Omega-3 fatty acid supplementation affects tryptophan metabolism during a 12-week endurance training in amateur runners: a randomized controlled trial.

The effects of long-term omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation during endurance training on tryptophan (Trp) metabolism and mental state of healthy individuals have not been evaluated so far. Concentrations of plasma Trp, its metabolites and IL-6 were assessed in 26 male runners before and after a 12-week training program combined with supplementation of n-3 PUFAs (O-3 + TRAIN group) or medium chain triglycerides (MCTs; TRAIN group). After the 12-week program participants' mood before and after stress induction was also assessed. The effects of the same supplementation protocol were evaluated also in 14 inactive subjects (O-3 + SEDEN group). Concentrations of 3-hydroxykynurenine (3-HK) and picolinic acid (PA) significantly increased only in the O-3 + TRAIN group (p = 0.01; [Formula: see text] = 0.22 and p = 0.01; [Formula: see text]= 0.26). Favorable, but not statistically significant changes in the concentrations of kynurenic acid (KYNA) (p = 0.06; [Formula: see text]= 0.14), xanthurenic acid (XA) (p = 0.07; [Formula: see text]= 0.13) and 3-hydroxyanthranilic acid (3-HAA) (p = 0.06; [Formula: see text]= 0.15) and in the ratio of neurotoxic to neuroprotective metabolites were seen also only in the O-3 + TRAIN group. No changes in mood and IL-6 concentrations were observed in either group. Supplementation with n-3 PUFAs during endurance training has beneficial effects on Trp's neuroprotective metabolites.Trial registry: This study was registered at ClinicalTrials.gov with identifier NCT05520437 (14/07/2021 first trial registration and 2018/31/N/NZ7/02962 second trial registration).

Interaction of aerobic exercise and crocin improves memory, learning and hypocampic tau and neurotrophins gene expression in rats treated with trimethytin as a model of Alzheimer's disease.

INTRODUCTION: Alzheimer's disease (AD) is characterized by progressive cognitive decline and a reduction in hippocampal neurotrophins, in which trimethytin (TMT) infusion causes tangles and neuronal dysfunction, creating an AD-like model in rats. Previous studies have demonstrated that crocin, which has anti-inflammatory properties, can enhance learning, memory acquisition, and cognitive behavior. This study aimed to assess the combined impact of aerobic exercise and crocin on memory, learning, and hippocampal Tau and neurotrophins gene expression in AD-like model rats. METHODS: Forty male Sprague Dawley rats were randomly divided into five groups: (1) healthy control, (2) Alzheimer's control, (3) endurance training, (4) crocin consumption, and (5) endurance training + crocin. Alzheimer's induction was achieved in groups 2-5 through intraperitoneal injection of 8 mg/kg TMT. Rats in groups 3 and 5 engaged in treadmill running three sessions per week, 15-30 min per session, at a speed of 15-20 m/min for eight weeks, and groups 4 and 5 received daily crocin supplementation of 25 mg/kg. RESULTS: Alzheimer's induction with TMT showed significant reduction in memory, learning, NGF, BDNF, and TrkB gene expression, and increase in tau gene expression (all p < 0.05). Notably, endurance training and crocin consumption separately significantly increased memory, learning, NGF, BDNF, and TrkB gene expression while significantly decreasing tau gene expression (all p < 0.05). Importantly, combined endurance training with crocin yielded the most profound effects on memory (p = 0.001), NGF (p = 0.002), BDNF (p = 0.001), and TrkB (p = 0.003) gene expression (p < 0.005), as well as a reduction in tau gene expression (p = 0.001). CONCLUSION: These findings underscore the possible impact of endurance training, particularly when coupled with crocin, on enhancing memory, learning, and neurotrophin gene expression and reducing tau gene expression in Alzheimer's rats. These results highlight the possibility of synergistic interventions for improved therapeutic outcomes.

Effect of respiratory muscle endurance training on performance and respiratory function in professional cyclists during the off-season.

BACKGROUND: The study aimed to analyze the effect of respiratory muscle endurance training (RMT) on performance and respiratory function in professional road cyclists during the off-season period. METHODS: Twenty professional road cyclists from the Czech Republic were divided into the control (CON) (N.=10) and the RMT (N.=10) groups. Cyclists from the RMT group accomplished 30 sessions over 10 weeks. Performance in the incremental cycling test and respiratory capacity via test were assessed before and after 10 weeks in both groups. The comparison between and within the groups was performed, together with effect size and delta % (P<0.05). RESULTS: Significant effects on respiratory function during the exercise, on lung volume utilization at 90% of VO2max (TV-90%) and maximal voluntary ventilation (MVV) were found in RMT compared to the CON group, with a moderate effect size (0.71 and 0.61), and improvements of 13% and 14%, respectively. Parameters of performance in the cycling protocol and respiratory function at rest presented better values in the RMT group, however with no significance and in minor magnitude. CONCLUSIONS: Using RMT during off-season benefits professional road cyclists by improving the major efficiency of respiratory function during progressive efforts. Therefore, the protocol of RMT could be used as an ergogenic aid during this period in order to maintain respiratory adaptations, optimizing the pre-season training. Adjustments can be made to improve the parameters outcomes.

Therapeutic effects of the combination of moderate-intensity endurance training and MitoQ supplementation in rats with isoproterenol-induced myocardial injury: The role of mitochondrial fusion, fission, and mitophagy.

INTRODUCTION: Mitochondrial dysfunction causes myocardial disease. This study investigated the effects of MitoQ alone and in combination with moderate-intensity endurance training (EX) on cardiac function and content and mRNA expression of several proteins involved in mitochondrial quality control in isoproterenol (ISO)-induced heart injuries METHODS: Seven groups of CTL, ISO, ISO-EX, ISO-MitoQ-125, ISO-MitoQ-250, ISO-EX+MitoQ-125, and ISO-EX+MitoQ-250 were assigned. Rats were trained on a treadmill, and the MitoQ groups received MitoQ in drinking water for 8 weeks, starting one week after the induction of heart injury. Arterial pressure and cardiac function indices, mRNA expression, protein content, oxidant and antioxidant markers, fibrosis, and histopathological changes were assessed by physiograph, Real-Time PCR, immunofluorescence, calorimetry, Masson's trichrome, and H&E staining, respectively. RESULTS: The impacts of MitoQ-125, EX+MitoQ-125, and EX+MitoQ-250 on arterial pressure and left ventricular systolic pressure were higher than MitoQ-250 or EX alone. ± dp/dt max were higher in ISO-EX+MitoQ-125 and ISO-EX+MitoQ-250 than ISO-MitoQ-125 and ISO-MitoQ-250 groups, respectively. Histopathological scores and fibrosis decreased in ISO-EX, ISO-MitoQ-125, ISO-EX+MitoQ-125, and ISO-EX+MitoQ-250 groups. The restoration of MFN2, PINK-1, and FIS-1 changes was higher in ISO-EX+MitoQ-125 and ISO-EX+MitoQ-250 than ISO-EX, ISO-MitoQ-125 and ISO-MitoQ-250 groups. The expression of MFN2 and PINK-1 was lower in ISO-MitoQ-125 and ISO-EX+MitoQ-125 than ISO and CTL groups. The expression of FIS-1 in ISO-EX and ISO-EX+MitoQ-250 increased compared to CTL and ISO groups. MDA decreased in ISO-MitoQ-125 and ISO-EX+MitoQ-125 groups. CONCLUSION: Exercise and MitoQ combination have additive effects on cardiac function by modulating cardiac mitochondria quality. This study provided a possible therapy to treat heart injuries.

Synergistic effect of endurance training and nettle leaf extract on the IDO1-KYN-AHR pathway homeostasis and inhibiting of liver toxicity in rats with STZ-induced diabetes.

Introduction: Diabetes adversely affects a number of hepatic molecular pathways, including the kynurenine (KYN) pathway. KYN is produced by indoleamine 2,3-dioxygenase (IDO) and activates the aryl hydrocarbon receptor (AHR). This study evaluated the effect of endurance training (EndTr) and nettle leaf extract (NLE) on the IDO1-KYN-AHR pathway in the livers of rats with streptozotocin-induced diabetes. Methods: We divided 48 rats into six groups: controls (Ct), treated with EndTr (EndTr), diabetes-induced (D), D treated with NLE (D + NLE), D treated with EndTr (D + EnTr), and D treated with EndTr and NLE (D + EndTr + NLE). EndTr, D + EnTr, and D + EndTr + NLE groups were subjected to training with running on treadmill for 8 weeks, 5 days per week, 25 min in first session to 59 min at last session with intensity of 55% to 65% VO2max. Using real-time PCR gene (Ahr, Cyp1a1, and Ido1) expressions and ELISA, malondialdehyde (MDA) and protein (IDO1, AHR, and CYP1A1) levels were determined in the liver samples. Results: A significant three-way interaction of exercise, nettle, and diabetes was observed on the all variables (P< 0.001). In particular, significant increases in blood glucose level (BGL), in gene and protein expression, and in MDA and KYN levels were observed in the liver samples of the D group versus the Ct group (P< 0.05). BGL and liver MDA levels were significantly lower in the D + EndTr and D + NLE groups than that in the D group. However, the D + EndTr + NLE group showed a more significant decrease in these factors (P< 0.05). In addition, liver KYN levels were significantly lower in the EndTr group compared with that in the Ct group as well as in the D + EndTr + NLE and D + EndTr groups compared with that in the D groups (P< 0.05). Whereas both the EndTr and D + NLE groups showed lower Ahr expression and AHR level compared with the Ct and D groups, respectively (P< 0.05), the D + EndTr + NLE group showed a higher significant reduction in the AHR level than the D group (P< 0.05). The Cyp1a1 expression and IDO1 level significantly decreased only in the D + EndTr + NLE group compared to that in the D group (P< 0.05). Conclusion: Overall, this study showed that the combination of EndTr and NLE may synergistically restore the imbalanced IDO1-KYN-AHR pathway in diabetic liver.

Programa Condicionamento Vocal e Respiratório (CVR II): nova proposta para profissionais da voz / Vocal and Respiratory Conditioning Program (CVR II): new proposal for voice professionals / Programa de Acondicionamiento Vocal y Respiratorio (CVR II): nueva propuesta para profesionales de la voz

Proposta recente de apresentação de Programa de Condicionamento Vocal e Respiratório (CVR I) incentivou a continuidade (CVR II), considerando novas estratégias de treinamento muscular vocal e respiratório que pudessem contribuir para melhor desempenho de profissionais da voz. Para a condução da ação, mais uma vez, houve a participação integrada de fonoaudiólogos e fisioterapeutas e, no papel de participantes, profissionais da voz. Planejada para dez encontros, em que dois deles (início e fim) foram destinados à coleta de dados, a proposta teve como objetivo aumentar ainda mais a resistência vocal e respiratória dos participantes, promovendo melhor rendimento profissional. Exercícios de trato vocal semiocluído e respiratórios foram realizados com o uso dos incentivadores denominados New Shaker® e Respiron Athletic 2®. Trata-se de mais uma experiência relatada na direção de convocar outros profissionais a colocarem em prática ações para o condicionamento vocal e respiratório de profissionais da voz. O uso de incentivadores respiratórios e a parceria com a Fisioterapia são apresentados e recomendados para melhor entendimento e consequente atendimento das questões da voz e da respiração. (AU)

This is a continuation (VRC II) of a recent proposal to present a Vocal and Respiratory Conditioning (VRC I) Program using new vocal and respiratory muscle training strategies aimed at contributing to a better performance of voice professionals. Once again, the initiative included the integrated participation of speech-language pathologists and physiotherapists, as well as voice professionals as participants. Ten meetings were planned in the initial proposal, with the first and last meeting focused on data collection, the proposal aimed to further increase the vocal and respiratory resistance of the participants, promoting better professional performance. Semi-occluded vocal tract and respiratory exercises were performed with using the New Shaker® and Respiron Athletic 2® boosters. This is an experience reported in order to encourage other professionals to put into practice actions for vocal and respiratory conditioning. The use of respiratory boosters and the partnership with Physiotherapy are recommended, aiming at a better understanding and consequent care of voice and breathing issues in voice professionals. (AU)

Una propuesta reciente de presentar un Programa de Acondicionamiento Vocal y Respiratório (CVR I) fomentó la continuidad (CVR II), considerando nuevas estratégias para el entrenamiento de los músculos vocales y respiratórios que podrían contribuir a un major desempeño de los profesionales de la voz. Para conducir la acción, una vez más, se contó con la participación integrada de fonoaudiológos y kinesiológos, y en el papel de participantes, profesionales de la voz. Planificada para diez encuentros, en los que dos de ellos (inicio y final) están destinados a la recolección de datos, la propuesta tiene como objetivo aumentar aún más la resistência vocal y respiratoria de los participantes, promoviendo un mejor desempeño profesional. Se realizaron ejercicios de tracto vocal y respiratorio semiocluidos con el uso de incentivos denominados New Shaker® y Respiron Athletic 2®. Esta es una experiencia más reportada en la dirección de invitar a otros profesionales a poner en práctica acciones para el acondicionamiento vocal y respiratório de los profesionales de la voz. Se presenta y recomienda el uso de soportes respiratórios y la asociación con Kinesiología para una mejor comprensión y consecuente atención de problemas de voz y respiración. (AU)

Stabilization of the cervical spine through flexor endurance training for Alice in Wonderland syndrome presenting as an aura of migraine- A case report.

BACKGROUND: Alice in Wonderland Syndrome is classified as a perceptual disorder. The sufferers report episodes of distorted visual perceptions, altered body schema, and distorted experiences of time. The syndrome can be caused by migraine headaches. Migraine headaches can be caused by cervical spine instability and aberrant intersegmental motion. METHODS: Training the deep neck flexor endurance lead to a reduction in migraine headaches and in turn a reduction or secession of the Alice in Wonderland Syndrome episodes. RESULTS: There is a resolution of the Alice in Wonderland Syndrome episodes after cervical spine stabilization is achieved. CONCLUSIONS: Training of the deep neck flexors shows promise as a primary treatment of migraine headaches and should be further investigated.

Respiratory muscle endurance training improves exercise performance but does not affect resting blood pressure and sleep in healthy active elderly.

PURPOSE: Ageing is associated with increased blood pressure (BP), reduced sleep, decreased pulmonary function and exercise capacity. The main purpose of this study was to test whether respiratory muscle endurance training (RMET) improves these parameters. METHODS: Twenty-four active normotensive and prehypertensive participants (age: 65.8 years) were randomized and balanced to receive either RMET (N = 12) or placebo (PLA, N = 12). RMET consisted of 30 min of volitional normocapnic hyperpnea at 60% of maximal voluntary ventilation while PLA consisted of 1 inhalation day-1 of a lactose powder. Both interventions were performed on 4-5 days week-1 for 4-5 weeks. Before and after the intervention, resting BP, pulmonary function, time to exhaustion in an incremental respiratory muscle test (incRMET), an incremental treadmill test (IT) and in a constant-load treadmill test (CLT) at 80% of peak oxygen consumption, balance, sleep at home, and body composition were assessed. Data was analyzed with 2 × 2 mixed ANOVAs. RESULTS: Compared to PLA, there was no change in resting BP (independent of initial resting BP), pulmonary function, IT performance, sleep, body composition or balance (all p > 0.05). Performance significantly increased in the incRMET (+ 6.3 min) and the CLT (+ 3.2 min), resulting in significant interaction effects (p < 0.05). CONCLUSION: In the elderly population, RMET might be used to improve respiratory and whole body endurance performance either as an adjunct to physical exercise training or as a replacement thereof for people not being able to intensively exercise even if no change in BP or sleep may be expected.

A comparison of the effects of inspiratory muscle strength and endurance training on exercise capacity, respiratory muscle strength and endurance, and quality of life in pacemaker patients with heart failure: A randomized study.

BACKGROUND: Studies have widely investigated the effects of inspiratory muscle strength training in patients with heart failure (HF). The effects of inspiratory muscle strength or endurance training on outcomes in patients with pacemakers have not been adequately studied. OBJECTIVES: The aim was to compare the effects of inspiratory muscle strength and endurance training on exercise capacity, quality of life (QoL), peripheral and respiratory muscle strength, respiratory muscle endurance, pulmonary function, dyspnea, fatigue, and physical activity levels in pacemaker patients with HF. METHODS: A randomized, controlled, double-blind study was conducted. Fourteen pacemaker patients with HF received inspiratory muscle strength training (IMST) at 50% of maximal inspiratory pressure (MIP), and 18 patients received endurance training (IMET) at 30% of MIP 7 days/8 weeks. Exercise capacity [6 min. walking test (6MWT) and the Incremental Shuttle Walking Test (ISWT)], pulmonary function, respiratory muscle strength [MIP, maximal expiratory pressure (MEP)], endurance, peripheral muscle strength, dyspnea, fatigue, QoL, and physical activity level were evaluated before and after. RESULTS: Demographic characteristics were similar in IMST (3F/11M, 56.92 ± 7.61y, EF: 25%, ICD/CRT:11/3) and IMET (4F/14M, 56 ± 10.77y, EF: 30%, ICD/CRT:16/2) groups (p > 0.05). Significant improvements were present in MIP, MEP, respiratory muscle endurance, peripheral muscle strength, 6MWT and ISWT walking distances, dyspnea, QoL, physical activity level, fatigue scores within groups (p ≤ 0.05). However, there were no significant differences between the groups (p > 0.05). There were no significant improvements in FEV1%, FVC%, FEV1/FVC%, and FEF25-75 within and between the groups (p > 0.05). CONCLUSIONS: Inspiratory muscle strength and endurance training similarly improves respiratory and peripheral muscle strength, exercise capacity, QoL, physical activity level, and decreases dyspnea and fatigue and are safe and effective in pacemaker patients with HF. TRIAL REGISTRATION: www. CLINICALTRIALS: gov; study number: NCT03501355.

Individually guided training prescription by heart rate variability and self-reported measure of stress tolerance in recreational runners: Effects on endurance performance.

The aim of this study was to determine the effect of endurance training individually guided by objective (Heart Rate Variability-HRV) or self-report measure of stress (DALDA-questionnaire) in comparison to predefined endurance training prescription for improving endurance performance in recreational runners. After a 2-week preliminary baseline period to establish resting HRV and self-reported measure of stress, thirty-six male recreational runners were randomly assigned to HRV-guided (GHRV; n = 12), DALDA-guided (GD; n = 12) or predefined training (GT; n = 12) prescription groups. Before and after 5-weeks of endurance training, participants performed a track field peak velocity (Vpeak_TF), time limit (Tlim) at 100% of Vpeak_TF and 5 km time-trial (5 km TT) tests. GD lead to higher improvements in Vpeak_TF (8.4 ± 1.8%; ES = 1.41) and 5 km TT (-12.8 ± 4.2%; ES = -1.97), than GHRV (6.6 ± 1.5% and -8.3 ± 2.8%; ES = -1.20; 1.24) and GT (4.9 ± 1.5% and -6.0 ± 3.3%; ES = -0.82; 0.68), respectively, with no differences for Tlim. Self-report measures of stress may be used to individualize endurance training prescription on a daily basis leading to better performance enhancement, which may be used with HRV for a holistic understanding of daily training-induce adaptations.

Physiological and performance effects of dietary nitrate and N-acetylcysteine supplementation during prolonged heavy-intensity cycling.

The purpose of this study was to investigate effects of concurrent and independent administration of dietary nitrate (NO3-), administered as NO3--rich beetroot juice (BR; ~12.4 mmol of NO3-), and N-acetylcysteine (NAC; 70 mg·kg-1) on physiological responses during prolonged exercise and subsequent high-intensity exercise tolerance. Sixteen recreationally active males supplemented with NO3--depleted beetroot juice (PL) or BR for 6 days and ingested an acute dose of NAC or maltodextrin (MAL) 1 h prior to performing 1 h of heavy-intensity cycling exercise immediately followed by a severe-intensity time-to-exhaustion (TTE) test in four conditions: 1) PL+MAL, 2) PL+NAC, 3) BR+MAL and 4) BR+NAC. Pre-exercise plasma [NO3-] and nitrite ([NO2-]) were elevated following BR+NAC  and BR+MAL (both P < 0.01) compared with PL+NAC and PL+MAL; plasma [cysteine] was increased in PL+NAC  and BR+NAC (both P < 0.01) compared to PL+MAL. Muscle excitability declined over time during the prolonged cycling bout in all conditions  but was better preserved in PL+NAC  compared to BR+NAC (P < 0.01) and PL+MAL (P < 0.05). There was no effect of supplementation on subsequent TTE . These findings indicate that co-ingestion of BR and NAC does not appreciably alter physiological responses during prolonged heavy-intensity cycling or enhance subsequent exercise tolerance.

Prevention and Treatment of Atrial Fibrillation via Risk Factor Modification.

Atrial fibrillation (AF) is the most common clinically significant arrhythmia, and it increases stroke risk. A preventive approach to AF is needed because virtually all treatments such as cardioversion, antiarrhythmic drugs, ablation, and anticoagulation are associated with high cost and carry significant risk. A systematic review was performed to identify effective lifestyle-based strategies for reducing primary and secondary AF. A PubMed search was performed using articles up to March 1, 2021. Search terms included atrial fibrillation, atrial flutter, exercise, diet, metabolic syndrome, type 2 diabetes mellitus, obesity, hypertension, stress, tobacco smoking, alcohol, Mediterranean diet, sodium, and omega-3 fatty acids. Additional articles were identified from the bibliographies of retrieved articles. The control of hypertension, ideally with a renin-angiotensin-aldosterone system inhibitor, is effective for preventing primary AF and recurrence. Obstructive sleep apnea is a common cause of AF, and treating it effectively reduces AF episodes. Alcohol increases the risk of AF in a dose-dependent manner, and abstinence reduces risk of recurrence. Sedentary behavior and chronic high-intensity endurance exercise are both risk factors for AF; however, moderate physical activity is associated with lower risk of AF. Recently, sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 agonists have been associated with reduced risk of AF. Among overweight/obese patients, weight loss of ≥10% is associated with reduced AF risk. Lifestyle changes and risk factor modification are highly effective for preventing AF.

Continuous Protein Supplementation Reduces Acute Exercise-Induced Stress Markers in Athletes Performing Marathon.

The aim of this study was to determine the changes in endurance performance and metabolic, hormonal, and inflammatory markers induced by endurance stress (marathon race) in a combined strategy of training and dietary protein supplementation. The study was designed as a randomised controlled trial consisting of regular endurance training without and with a daily intake of a soy protein-based supplement over a three-month period in 2 × 15 (10 males and 5 females per group) endurance-trained adults. Body composition (body mass, BMI, and fat mass) was determined, and physical fitness was measured by treadmill ergometry at baseline and after 3 months of intervention; changes in exercise-induced stress and inflammatory markers (CK, myoglobin, interleukin-6, cortisol, and leukocytes) were also determined before and after a marathon competition; eating behaviour was documented before and after intervention by a three-day diet diary. Although no significant influence on endurance performance was observed, the protein supplementation regime reduced the exercise-induced muscle stress response. Furthermore, a protein intake of ≥20% of total energy intake led to a lower-level stress reaction after the marathon race. In conclusion, supplementary protein intake may influence exercise-induced muscle stress reactions by changing cellular metabolism and inflammatory pathways.

Effects of specific inspiratory muscle training combined with whole-body endurance training program on balance in COPD patients: Randomized controlled trial.

PURPOSE: This study aims to assess the effect of inspiratory muscle training (IMT) combined with endurance training (ET) on balance in patients with chronic obstructive pulmonary disease (COPD). METHODS: We studied 32 male patients (62 ± 6 years) with moderate to very severe COPD. They were randomly assigned to an experimental group (IMT+ET) n = 16 or a control group (ET) n = 16 with similar characteristics. The evaluations were carried out at inclusion and after eight weeks of the training period. Functional balance was assessed by the Berg Balance Scale (BBS), the Timed-up and Go (TUG), the Single Leg Stance test (SLS), and the Activities-specific Balance Confidence (ABC) scale. The strength of the inspiratory muscles (PImax) was assessed by maximal inspiratory mouth pressure. Functional exercise performance was assessed by the 6 minutes walking test (6MWT). IMT program consists in performing two daily sets of 30 inspirations with 50% of PImax increased by 10% every two weeks. ET program consists in performing 30 min treadmill exercise at 60% to 80% of the average speed achieved during the 6MWT three days per week. RESULTS: After the training period, the experimental group demonstrated greater improvements in BBS (IMT+ET vs. ET; p = 0.019), and in ABC (IMT+ET vs. ET; p = 0.014). However, no significant differences between groups were observed for TUG, SLS, and 6MWT. There was a significant difference between groups in PImax (IMT+ET vs. ET; p = 0.030). Significant moderate correlations were obtained between ΔPImax and ΔBBS for both groups (IMT+ET: r = 0.624, p = 0.010; ET r = 0.550, p = 0.027) as well as for ΔABC but only in the experimental group (IMT+ET: r = 0.550, p = 0.027). CONCLUSION: Compared to ET alone, the results suggest that IMT combined with ET enhances inspiratory muscle function and functional balance according to BBS and ABC in patients with COPD. We suggest that inspiratory muscle training might be introduced as additional training to pulmonary rehabilitation programs aimed at improving balance in COPD patients. TRIAL REGISTRATION: The trial registry name: Clinical Trials; Registration number: NCT04084405; URL: https://clinicaltrials.gov/ct2/show/NCT04084405.

Promoting a pro-oxidant state in skeletal muscle: Potential dietary, environmental, and exercise interventions for enhancing endurance-training adaptations.

Accumulating evidence now shows that supplemental antioxidants including vitamin C, vitamin E and N-Acetylcysteine consumption can suppress adaptations to endurance-type exercise by attenuating reactive oxygen and nitrogen species (RONS) formation within skeletal muscle. This emerging evidence points to the importance of pro-oxidation as an important stimulus for endurance-training adaptations, including mitochondrial biogenesis, endogenous antioxidant production, insulin signalling, angiogenesis and growth factor signaling. Although sustained oxidative distress is associated with many chronic diseases, athletes have, on average, elevated levels of certain endogenous antioxidants to maintain redox homeostasis. As a result, trained athletes may have a better capacity to buffer oxidants during and after exercise, resulting in a reduced oxidative eustress stimulus for adaptations. Thus, higher levels of RONS input and exercise-induced oxidative stress may benefit athletes in the pursuit of continuous endurance training redox adaptations. This review addresses why athletes should be looking to enhance exercise-induced oxidative stress and how it can be accomplished. Methods covered include high-intensity interval training, hyperthermia and heat stress, dietary antioxidant restriction and modified antioxidant timing, dietary antioxidants and polyphenols as adjuncts to exercise, and vitamin C as a pro-oxidant.

Altered endocannabinoid-dynamics in craniopharyngioma patients and their association with HPA-axis disturbances.

OBJECTIVE: Patients with craniopharyngioma (CP) frequently suffer from morbid obesity. Endocannabinoids (ECs) are involved in weight gain and rewarding behavior but have not been investigated in this context. DESIGN: Cross-sectional single-center study. METHODS: Eighteen patients with CP and 16 age- and sex-matched controls were included. Differences in endocannabinoids (2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA)) and endocannabinoid-like molecules (oleoyl ethanolamide (OEA), palmitoylethanolamide (PEA), and arachidonic acid (AA) were measured at baseline and following endurance exercise. We further explored ECs-dynamics in relation to markers of HPA-axis activity (ACTH, cortisol, copeptin) and hypothalamic damage. RESULTS: Under resting conditions, independent of differences in BMI, 2-AG levels were more than twice as high in CP patients compared to controls. In contrast, 2-AG and OEA level increased in response to exercise in controls but not in CP patients, while AEA levels decreased in controls. As expected, exercise increased ACTH and copeptin levels in controls only. In a mixed model analysis across time and group, HPA measures did not provide additional information for explaining differences in 2-AG levels. However, AEA levels were negatively influenced by ACTH and copeptin levels, while OEA levels were negatively predicted by copeptin levels only. There were no significant differences in endocannabinoids depending on hypothalamic involvement. CONCLUSION: Patients with CP show signs of a dysregulated endocannabinoid system under resting conditions as well as following exercise in comparison to healthy controls. Increased 2-AG levels under resting conditions and the missing response to physical activity could contribute to the metabolic phenotype of CP patients.

Effect of eight-week curcumin supplementation with endurance training on glycemic indexes in middle age women with type 2 diabetes in Iran, A preliminary study.

BACKGROUND AND AIMS: The purpose of this study was to determine the effects of curcumin supplementation & endurance training on glycemic indexes in middle-aged women with type 2 diabetes. METHODS: 40 middle-aged women with type 2 diabetes were randomly divided into four groups (control, curcumin, training & curcumin + training). Endurance training protocol included running on treadmill for eight weeks, three sessions per week and each session for 45-60 min, with a maximum intensity of 50-70% of MHR. The experimental groups received a supplementation of curcumin as a daily dose of 80 mg curcumin soft gel for 8 weeks while the control group was subjected to no supplementation or exercise during this period. One day before and one day after the eight-week experimental period, blood samples were taken from the subjects to measure the glycemic indexes, including fasting blood glucose, glycosylated hemoglobin, and serum insulin levels. T-test and two-way covariance analysis tests were used for analyzing the findings at a significant level of less than 0.05. RESULTS: Eight weeks of curcumin supplementation and endurance training, whether done separately or simultaneously, significantly reduced fasting blood glucose, glycosylated hemoglobin and serum insulin levels (P < 0.05). The combination of curcumin supplementation and endurance training compared to the other two interventions caused a significant further decrease in these glycemic indexes (P < 0.05). CONCLUSION: The findings of this study showed that eight weeks of curcumin supplementation and endurance training helped each other in improving the glycemic indexes of women with type 2 diabetes.

Exercise prehabilitation in lung cancer: Getting stronger to recover faster.

Despite several recent advances, lung cancer surgery is still associated with potentially severe postoperative complications. It has been suggested that preoperative exercise training could render patients with borderline functional parameters eligible for surgery, improve perioperative outcomes and that these benefits might reduce healthcare costs. Nevertheless, given the substantial heterogeneity of the available studies, no specific guidelines for preoperative exercise training have been released so far. This narrative review aims to provide an overview of the potential benefits of exercise training in the preoperative period as a central intervention for lung cancer patients. In detail, the effects of exercise (with different regimens) were evaluated in terms of physical functions, patients' eligibility for curative surgery, postoperative complications and length of stay, with an exploratory focus on healthcare costs and long-term outcomes. Furthermore, a feasible approach for every-day clinical practice is proposed in order to increase the expected benefit deriving from a more extensive and methodical application of prehabilitation exercise, ideally in the context of a comprehensive approach to lung cancer patients, including nutritional and psychological support.

Effect of whey vs. soy protein supplementation on recovery kinetics following speed endurance training in competitive male soccer players: a randomized controlled trial.

BACKGROUND: Soccer-specific speed-endurance training induces short-term neuromuscular fatigue and performance deterioration over a 72-h recovery period, associated with elevated markers of exercise-induced muscle damage. We compared the effects of whey vs. soy protein supplementation on field activity, performance, muscle damage and redox responses following speed-endurance training in soccer players. METHODS: Ten well-trained, male soccer players completed three speed-endurance training trials, receiving whey protein (WP), soy protein (SP) or an isoenergetic placebo (PL; maltodextrin) according to a randomized, double-blind, crossover, repeated-measures design. A pre-loading period was applied in each trial during which protein supplementation was individually adjusted to reach a total protein intake of 1.5 g/kg/day, whereas in PL protein intake was adjusted at 0.8-1 g/kg/day. Following pre-loading, two speed-endurance training sessions (1 and 2) were performed 1 day apart, over a 3-day experimental period. During each session, field activity and heart rate were continuously monitored using global positioning system and heart rate monitors, respectively. Performance (isokinetic strength of knee extensors and flexors, maximal voluntary isometric contraction, speed, repeated sprint ability, countermovement jump), muscle damage (delayed-onset of muscle soreness, creatine kinase activity) and redox status (glutathione, total antioxidant capacity, protein carbonyls) were evaluated at baseline (pre), following pre-loading (post-load), and during recovery from speed-endurance training. RESULTS: High-intensity and high-speed running decreased (P ≤ 0.05) during speed-endurance training in all trials, but WP and SP mitigated this response. Isokinetic strength, maximal voluntary isometric contraction, 30-m speed, repeated sprint ability and countermovement jump performance were similarly deteriorated during recovery following speed-endurance training in all trials (P ≤ 0.05). 10 m speed was impaired at 24 h only in PL. Delayed-onset of muscle soreness, creatine kinase, total antioxidant capacity and protein carbonyls increased and glutathione decreased equally among trials following speed-endurance training (P ≤ 0.05), with SP inducing a faster recovery of protein carbonyls only at 48 h (P ≤ 0.05) compared to WP and PL. CONCLUSIONS: In conclusion, increasing daily protein intake to 1.5 g/kg through ingestion of either whey or soy protein supplements mitigates field performance deterioration during successive speed-endurance training sessions without affecting exercise-induced muscle damage and redox status markers. TRIAL REGISTRATION: Name of the registry: clinicaltrials.gov. TRIAL REGISTRATION: NCT03753321 . Date of registration: 12/10/2018.

Increased cardiorespiratory stress during submaximal cycling after ketone monoester ingestion in endurance-trained adults.

There is growing interest in the effect of exogenous ketone body supplementation on exercise responses and performance. The limited studies to date have yielded equivocal data, likely due in part to differences in dosing strategy, increase in blood ketones, and participant training status. Using a randomized, double-blind, counterbalanced design, we examined the effect of ingesting a ketone monoester (KE) supplement (600 mg/kg body mass) or flavour-matched placebo in endurance-trained adults (n = 10 males, n = 9 females; V̇O2peak = 57 ± 8 mL/kg/min). Participants performed a 30-min cycling bout at ventilatory threshold intensity (71 ± 3% V̇O2peak), followed 15 min later by a 3 kJ/kg body mass time-trial. KE versus placebo ingestion increased plasma ß-hydroxybutyrate concentration before exercise (3.9 ± 1.0 vs 0.2 ± 0.3 mM, p < 0.0001, dz = 3.4), ventilation (77 ± 17 vs 71 ± 15 L/min, p < 0.0001, dz = 1.3) and heart rate (155 ± 11 vs 150 ± 11 beats/min, p < 0.001, dz = 1.2) during exercise, and rating of perceived exertion at the end of exercise (15.4 ± 1.6 vs 14.5 ± 1.2, p < 0.01, dz = 0.85). Plasma ß-hydroxybutyrate concentration remained higher after KE vs placebo ingestion before the time-trial (3.5 ± 1.0 vs 0.3 ± 0.2 mM, p < 0.0001, dz = 3.1), but performance was not different (KE: 16:25 ± 2:50 vs placebo: 16:06 ± 2:40 min:s, p = 0.20; dz = 0.31). We conclude that acute ingestion of a relatively large KE bolus dose increased markers of cardiorespiratory stress during submaximal exercise in endurance-trained participants. Novelty: Limited studies have yielded equivocal data regarding exercise responses after acute ketone body supplementation. Using a randomized, double-blind, placebo-controlled, counterbalanced design, we found that ingestion of a large bolus dose of a commercial ketone monoester supplement increased markers of cardiorespiratory stress during cycling at ventilatory threshold intensity in endurance-trained adults.