The algorithm used for the calculation of gas exchange affects the estimation of O2 uptake kinetics at the onset of moderate-intensity exercise.

At the start of a moderate-intensity square-wave exercise, after a short delay, breath-by-breath O2 uptake at the mouth is approximated to a mono-exponential function, whose time constant is considered matched to that of the O2 uptake of the working muscles. We compared the kinetic parameters obtained from the breath-by-breath gas exchange data yielded by the 'Independent-breath' algorithm (IND), which accounts for the changes in lung gas stores, with those obtained with the classical 'Expiration-only' algorithm (EXP). The two algorithms were applied on the same flow and gas fraction traces acquired on 10 healthy volunteers, performing 10 times the same moderate-intensity exercise transition. Repeated O2 uptake responses were stacked together and the kinetic parameters of a mono-exponential function were estimated by non-linear regression, removing the data pertaining to 1-s progressively longer initial periods (ΔTr ). Independently of ΔTr , the mean response time (time constant + time delay) obtained for the IND data was faster compared to the EXP data (∼43 s vs. ∼47 s, P < 0.001), essentially because of shorter time delays. Between ΔTr  = 16 s and ΔTr  = 29s, the time constants of the IND data decreased (30.7 s vs. 28.0 s, P < 0.05; drop = 10%), but less than those of the EXP data (32.2 s vs. 26.2 s, P < 0.001; drop = 23%); with the same ΔTr , the time constants of the two algorithms' data were not different (P > 0.07). The different decrease in the time constant, together with the different mean response time, suggests that the data yielded by the two algorithms provide a different picture of the phenomena occurring at the beginning of the exercise.

A strategy to implement the American College of Sports Medicine's Exercise is Medicine® (EIM) initiative in a community oncology clinic.

PURPOSE: Despite proven benefits, few cancer patients exercise during chemotherapy. The American College of Sports Medicine's Exercise is Medicine® (EIM) initiative describes a model to integrate exercise into oncology care, based upon assessing patients' ability to exercise safely, advising on exercise benefits, and referring patients to exercise. We developed and tested a strategy to implement EIM in a community-based oncology clinic, to assess-advise-refer 20 patients undergoing chemotherapy to a 3-month online exercise class, and measured implementation outcomes. METHODS: Using a community-based provider participation in research (CBPPR) model, researchers and staff co-designed and tested a 4-level implementation strategy, with a goal of assessing-advising-referring 20 cancer patients to exercise. Surveys and interviews were conducted with 12 (100%) staff at baseline and post-implementation on acceptability/appropriateness/feasibility, perceptions of individual implementation roles, and organizational strengths/conditions. Data were analyzed using correlations, t-tests, and content analysis. RESULTS: The proposed strategy was revised in collaboration with staff who requested assistance for recruitment and data collection. EIM was successfully implemented with 41 (92%) patients assessed, 37 (90%) advised, and 22 (60%) referred to exercise classes. Barriers to implementation were staff shortages and time constraints; facilitators included research team supports. Staff's perceived organizational strengths were positively correlated with exercise promotion acceptability, appropriateness, and feasibility. There were no statistically significant changes in implementation outcomes (acceptability/appropriateness/feasibility) post-implementation. CONCLUSIONS: Using a collaborative model, EIM was successfully implemented in a community oncology clinic; however, the clinic required significant support from the research team. Adaptations to the EIM process may be required to improve implementation outcomes.

Acute alcohol ingestion decreases the work done above the end-test power during a 3-min all-out cycling exercise.

INTRODUCTION: Alcohol ingestion influences metabolism during a subsequent exercise session, as evidenced by increased blood lactate concentration during fixed-intensity exercise. Therefore, augmented blood concentrations of alcohol may interfere with the anaerobic metabolism during high-intensity, short-duration exercise bout, thereby leading to impaired athletic performance. OBJECTIVE: This study investigated whether the acute ingestion of alcohol as ethanol modulates performance parameters derived from the power-duration relationship in a 3-min all-out cycling test that allows for identifying the power output related to heavy and severe exercise intensities. METHODS: Twenty-four recreationally active cyclists (16 men and 8 women) ingested a beverage containing either 0.4 g ethanol.kg-1 body mass (EtOH) or a placebo (PLA) solution. Thirty minutes following ingestion, they completed a 3-min all-out test to measure power output and determine the end-test power (EP) and the work done above EP (WEP). RESULTS: Alcohol ingestion decreased WEP by 16% (EtOH: 5.6 ± 2.5 kJ vs. PLA: 6.7 ± 2.4 kJ; P = .003) but did not change EP (EtOH: 211 ± 44 W vs. PLA: 212 ± 44 W; P = .671). The alcohol-mediated effect in WEP was not influenced when controlling for participants' sex or accuracy in identifying the beverage ingested. CONCLUSION: Our data indicate that alcohol ingestion impaired the anaerobic work capacity, as evidenced by the reduction in WEP during the 3-min all-out test. Moreover, the ability to exercise at an intensity above the heavy domain may be decreased after ingestion of a moderate alcohol dose.

Evaluation of salivary α-amylase and immunoglobulin A responses after endurance exercise in adolescent males and females with similar aerobic fitness.

The objective of this study was to clarify whether there are sex-specific differences in salivary α-amylase and immunoglobulin A responses following acute endurance exercise in adolescent males and females with equivalent cardiorespiratory fitness levels. Twenty-six aerobically trained adolescent males and females with similar training status were enrolled in this study. Each individual executed a 1-h prolonged cycling exercise corresponding to a constant power output at 65% of peak oxygen uptake. Unstimulated whole salivary samples were taken with the passive drooling method at the 10-min period before and after exercise for the determination of salivary responses [α-amylase, immunoglobulin A, total protein and flow rate]. Salivary α-amylase activity, immunoglobulin A concentration and total protein concentration were significantly augmented immediately after acute endurance exercise. Regarding sex differences, only the salivary flow rate was significantly lower in females than in males. The findings of the present study imply that adolescent males and females appear to have similar salivary responses after acute endurance exercise, as represented by salivary α-amylase activity and immunoglobulin A concentration in connection with total protein concentration and salivary flow rate, when they are matched for peak oxygen uptake relative to fat-free body mass.

Central effects of mouth rinses on endurance and strength performance.

Rinsing the mouth with a carbohydrate (CHO) solution has been shown to enhance exercise performance while reducing neuromuscular fatigue. This effect is thought to be mediated through the stimulation of oral receptors, which activate brain areas associated with reward, motivation, and motor control. Consequently, corticomotor responsiveness is increased, leading to sustained levels of neuromuscular activity prior to fatigue. In the context of endurance performance, the evidence regarding the central involvement of mouth rinse (MR) in performance improvement is not conclusive. Peripheral mechanisms should not be disregarded, particularly considering factors such as low exercise volume, the participant's fasting state, and the frequency of rinsing. These factors may influence central activations. On the other hand, for strength-related activities, changes in motor evoked potential (MEP) and electromyography (EMG) have been observed, indicating increased corticospinal responsiveness and neuromuscular drive during isometric and isokinetic contractions in both fresh and fatigued muscles. However, it is important to note that in many studies, MEP data were not normalised, making it difficult to exclude peripheral contributions. Voluntary activation (VA), another central measure, often exhibits a lack of changes, mainly due to its high variability, particularly in fatigued muscles. Based on the evidence, MR can attenuate neuromuscular fatigue and improve endurance and strength performance via similar underlying mechanisms. However, the evidence supporting central contribution is weak due to the lack of neurophysiological measures, inaccurate data treatment (normalisation), limited generalisation between exercise modes, methodological biases (ignoring peripheral contribution), and high measurement variability.Trial registration: PROSPERO ID: CRD42021261714.

Implementation of Exercise Management Services Among Sports Medicine Physicians in the United States.

OBJECTIVE: Assessment of physical activity and exercise prescription has been widely supported by many organizations, yet provision of such services remains limited in the United States. We sought to uncover why such services have not been widely adopted. DESIGN: The American Medical Society for Sports Medicine organized a task force to canvas physicians and survey the American Medical Society for Sports Medicine membership. SETTING: Peer-to-peer and telecommunication discussions and web-based questionnaires. PARTICIPANTS: Sports medicine physicians in the United States. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Percentage of sports medicine physicians who provide exercise management services and mechanisms of billing for exercise management, identify barriers to such services, and identify industry collaborations for promoting physical activity through physicians. RESULTS: Three of 4 sports medicine physicians spend at least 1 min encouraging exercise with patients, using Evaluation and Management codes to bill or receive credit. Exercise counseling is often bundled within other patient care. Few health plans leverage the patient's relationship with a primary care physician to promote exercise. Most employed sports medicine physicians do not receive incentives to incorporate exercise counseling into practice, and only 1 in 6 have decision-making authority to hire an exercise professional. Major obstacles are the lack of a business model and knowledge about exercise prescription. CONCLUSION: The existing E&M codes adequately characterize the work, but physicians desire greater payment or credit for providing exercise management services. Physicians desire to do more exercise prescription, but health system bureaucracy, inadequate support, and economic disincentives are barriers to the provision of exercise management services.

Developing and Validating an Intelligent Mouth-Opening Training Device: A New Solution for Restricted Mouth Opening.

Restricted mouth opening (trismus) is one of the most common complications following head and neck cancer treatment. Early initiation of mouth-opening exercises is crucial for preventing or minimizing trismus. Current methods for these exercises predominantly involve finger exercises and traditional mouth-opening training devices. Our research group successfully designed an intelligent mouth-opening training device (IMOTD) that addresses the limitations of traditional home training methods, including the inability to quantify mouth-opening exercises, a lack of guided training resulting in temporomandibular joint injuries, and poor training continuity leading to poor training effect. For this device, an interactive remote guidance mode is introduced to address these concerns. The device was designed with a focus on the safety and effectiveness of medical devices. The accuracy of the training data was verified through piezoelectric sensor calibration. Through mechanical analysis, the stress points of the structure were identified, and finite element analysis of the connecting rod and the occlusal plate connection structure was conducted to ensure the safety of the device. The findings support the effectiveness of the intelligent device in rehabilitation through preclinical experiments when compared with conventional mouth-opening training methods. This intelligent device facilitates the quantification and visualization of mouth-opening training indicators, ensuring both the comfort and safety of the training process. Additionally, it enables remote supervision and guidance for patient training, thereby enhancing patient compliance and ultimately ensuring the effectiveness of mouth-opening exercises.

Combined effect of dietary calcium consumption and physical activity on dental caries in children and adolescents: a study of the NHANES database.

BACKGROUND: Calcium (Ca) is a nutritional factor that associated with dental caries. A recent study showed that in the case of adequate Ca intake, a higher level of physical activity may contribute to bone mass accumulation. However, the combined effect between Ca intake and physical activity on caries experience is unclear. Herein, we aimed to explore the above combined effect on dental caries in children and adolescents. METHODS: Data of 5,917 children and adolescents were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2015-2020 in this cross-sectional study. The NHANES assessed the dietary Ca intake through the 24-hour dietary recalls, and the physical activity level was self-reported using the questionnaires. Also, the dental caries was diagnosed according to the Decayed, Missing and Filled Teeth/Surfaces (DMFT/S) index. Weighted univariate and multivariate logistic regression analyses were utilized to screen the covariates and to investigate the associations of dietary Ca intake and physical activity with dental caries, respectively, and assess the combined effect between dietary Ca intake and physical activity on dental caries. The evaluation indexes were odd ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses of age, obesity, and total sugar intake were also performed. RESULTS: Among the eligible participants, 2,687 had caries experience. After adjusting for the covariates, we found that children and adolescents who not reach the recommendation level of Ca intake combined with physical activity less than 7 time in 1 week seemed to have higher odds of dental caries [OR = 1.77, 95%CI: (1.38-2.27)], compared with those who reached the standards. In addition, this potential combined effect was also found in age < 12 years old [OR = 1.62, 95%CI: (1.23-2.14)], non-obesity [OR = 1.88, 95%CI: (1.49-2.35)], and total sugar intake (all P < 0.05) subgroups. CONCLUSIONS: Ca intake and physical activity had a potential combined effect on dental caries in children and adolescents, but the causal relationships between them needed further clarification.

Association between modifiable lifestyle pattern and periodontitis: a cross-sectional study based on NHANES.

BACKGROUND: Periodontitis can be avoided with a healthy lifestyle. However, studies have only looked at one lifestyle, ignoring the connection between lifestyle patterns and periodontitis. The purpose of this study was to look at the association between modifiable lifestyle patterns and periodontitis. METHODS: Data were obtained from the National Health and Nutrition Examination Survey in 2009-2010 and 2011-2012. Smoke, drink, exercise, sleep duration, oral exams, and self-rated oral health were all lifestyle factors. The CDC/AAP classification/case definition was used to evaluate periodontitis. Drawing upon latent class analysis, distinct patterns of lifestyle were identified, with each participant exclusively affiliated with a single pattern. The association between lifestyle classes and periodontitis was then examined using ordinal logistic regression. RESULTS: 4686 (52%) of the total 9034 participants, with a mean age of 54.08, were women. Three lifestyle latent classes were found by fitting 2-10 models: "Class 1" (52%), " Class 2" (13%), and " Class 3" (35%). The "Class 1" displayed a prevalence of oral examination (75%), favorable self-rated oral health (92%), and engagement in physical activity (50%). The 'Class 2' exhibited the lowest alcohol consumption (64%) and smoking rates (73%) but the highest prevalence of physical inactivity (98%). The 'Class 3' showed a tendency for smoking (72%), alcohol consumption (78%), shorter sleep duration (50%), absence of oral examinations (75%), and suboptimal self-rated oral health (68%). The influencing variables for the latent classes of lifestyle were age, education, and poverty level. Periodontitis risk may rise by 24% for each additional unhealthy lifestyle practiced by participants (OR = 1.24, 95% CI: 1.18-1.31). The 'Class 3' (OR = 1.80, 95% CI: 1.52-2.13) had a greater risk of periodontitis compared to the 'Class 1'. CONCLUSIONS: Our analysis revealed that unhealthy lifestyle patterns are associated with periodontitis. These different lifestyle patterns need to be taken into account when developing public health interventions and clinical care.

NHANES-based analysis of the correlation between leisure-time physical activity, serum cotinine levels and periodontitis risk.

OBJECTIVE: To investigate the association of leisure-time physical activity and serum cotinine levels with the risk of periodontitis in the general population and to further analyze the interaction between leisure-time physical activity and serum cotinine levels on the risk of periodontitis. METHODS: This was a cross-sectional study, extracting data from 9605 (56.19%) participants in the National Health and Nutrition Examination Survey (NHANES) database from 2009 to 2014, and analyzing the relationship and interaction effects of serum cotinine level, leisure time physical activity, and risk of periodontitis by weighted univariate logistic modeling; Effect sizes were determined using ratio of ratios (OR), 95% confidence intervals (95% CI). RESULTS: 5,397 (56.19%) of 9,605 participants had periodontitis; an increased risk of periodontitis was found in those in the leisure time physical activity intensity < 750 MET × min/week group (OR = 1.44, 95% CI: 1.17-1.78). Serum cotinine levels ≥ 0.05 ng/ml were associated with an increased risk of periodontitis (OR = 1.99, 95% CI: 1.69-2.33). The group with low leisure physical activity and serum cotinine levels ≥ 0.05 ng/ml had an increased risk of periodontitis compared to the group with high leisure physical activity and serum cotinine levels < 0.05 ng/ml (OR = 2.48, 95% CI: 1.88-3.27). Interaction metrics RERI = 0.90 (95% CI: 0.44-1.36) and API = 0.36 (95% CI: 0.18-0.55); CI for SI = 2.55 (95% CI: 1.03-6.28). for API 0.36. CONCLUSION: Leisure time physical activity intensity interacted with smoking exposure on periodontitis risk and may provide the general population with the opportunity to Increasing leisure-time physical activity and smoking cessation may provide recommendations for the general population.

Effect of carbohydrate mouth rinse on muscle strength and muscular endurance: A systematic review with meta-analysis.

The present systematic review with meta-analysis summarized studies that investigated the effect of carbohydrate (CHO) mouth rinse on muscle strength and muscular endurance. The search was performed in six databases. Thirteen randomized clinical trials were selected and the standardized mean difference between CHO mouth rinse and placebo for maximal strength and muscular endurance was determined via a random-effects model using Review Manager 5.4 software. Meta-regression was also performed to explore the influence of load, number of sets, number of exercises, fasting time, CHO concentration, and number of mouth rinses on the main outcomes. There was no significant effect of CHO mouth rinse on maximal strength (mean difference= 0.25 kg, 95%CI - 1.81 to 2.32 kg, z = 0.24, p = 0.810). However, there was a significant positive effect of CHO mouth rinse on muscular endurance (mean difference = 1.24 repetitions, 95%CI 0.70 to 1.77 repetitions, z = 4.55, p < 0.001). Meta-regression identified that CHO mouth rinse has greater benefits on muscular endurance when using high workloads, multiple exercises, and a smaller number of mouth rinses (p = 0.001). In conclusion, CHO mouth rinse has no effect on maximal muscle strength but has a positive effect on muscular endurance and seems to optimize when fewer mouth rinses, high workloads and numbers of exercises are used.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2057417.

The effectiveness of walking exercise on the bowel preparation before colonoscopy: a single blind randomized clinical trial study.

BACKGROUND AND AIM: Bowel preparation is a crucial factor affecting the diagnostic accuracy of colonoscopy, and few randomized control trials evaluated enhancement in bowel preparation. In this study, we aimed to evaluate the effectiveness of walking exercises on bowel preparation before a colonoscopy procedure. METHODS: The present study is a single-blind randomized controlled trial involving 262 patients scheduled for colonoscopy procedures. These patients were randomly assigned to two groups: an intervention group (n = 131) and a control group (n = 131). In the intervention group, participants followed a predetermined plan that included the consumption of specific liquids and foods, bisacodyl pills, polyethylene glycol powder, and a regimen of walking exercises in preparation for their colonoscopy. Conversely, individuals in the control group followed the same regimen but were not instructed to engage in walking exercises. On the day of the colonoscopy, both groups were assessed for their level of physical activity using a foot counter. Additionally, an experienced gastroenterologist evaluated and compared the bowel preparation between the two groups using the Boston Bowel Preparation Scale (BBPS). RESULTS: The number of footsteps recorded in the two groups exhibited a significant difference (P < 0.001). Although there was no statistically significant difference between the intervention and control groups in terms of mean BBPS scores (6.26 ± 1.9 vs. 6.29 ± 1.9, P = 0.416), individuals who took more than 6900 steps had significantly higher BBPS scores compared to those with fewer than 6900 footsteps (6.62 ± 1.8 vs. 5.92 ± 1.9, P = 0.003).In the univariate analysis, BBPS was found to be significantly associated with individuals under the age of 50 (OR: 2.45, 95% CI: 1.30-4.61, P = 0.006) and smoking status (OR: 0.41, 95% CI: 0.17-0.94, P = 0.043). In the multivariate analysis, the relationship between BBPS and age below 50 and smoking remained significant (OR: 2.50, 95% CI: 1.30-4.70, P = 0.005, and OR: 0.38, 95% CI: 0.16-0.93, P = 0.034, respectively). CONCLUSION: A higher number of footsteps taken especially more than 6900 can significantly enhance bowel preparation; however, walking exercise as an intervention before colonoscopy is not significantly associated with BBPS. Also, older people and smokers seem to have fewer benefits from walking exercises for bowel preparation. TRIAL REGISTRATION: ISRCTN32724024 (Registration date:22/08/2018).

A cross-sectional study of the association between periodontitis and physical activity in the Japanese population.

OBJECTIVE: The aim of this study was to determine whether physical activity (PA) is associated with periodontitis in the Japanese population. BACKGROUND: The potential association between PA and periodontitis has not been thoroughly investigated in the Japanese population. METHODS: We used cross-sectional data from the Japan Public Health Center-based Prospective Study for the Next-Generation Oral Health Study. Periodontitis was determined by a full-mouth periodontal examination. PA was assessed using a validated questionnaire. We performed multivariable ordinal logistic regression analyses to assess the association of total PA (the first quintile was set as the reference category) with periodontitis (three categories: no/mild, moderate, and severe), stratified by sex. The associations of periodontitis with domain- and intensity-specific PA were also studied in separate logistic regression models. RESULTS: This study included 2160 Japanese adults [1414 women and 746 men; mean (standard deviation) age 58.1 (9.6) years]. After adjusting for potential confounders, total PA was inversely associated with the presence and severity of periodontitis in women. The multivariable-adjusted odds ratios (95% confidence intervals) for periodontitis in the second to fifth quintiles (compared with the first quintile) of total PA were 0.81 (0.59-1.12), 0.74 (0.53-1.02), 0.77 (0.55-1.06), and 0.64 (0.46-0.89), respectively (p for trend = .01). We did not find different results when we further investigated the associations of periodontitis with domain- and intensity-specific PA. By contrast, PA was not associated with periodontitis in men. CONCLUSION: Total PA had an inverse, linear association with the presence and severity of periodontitis in Japanese women but not in Japanese men. Further prospective studies are required to determine the association between PA and periodontitis.

Effectiveness of exercise therapy for individuals diagnosed with Charcot-Marie-Tooth disease: A systematic review of randomized clinical trials.

BACKGROUND AND AIMS: Effective treatments for Charcot-Marie-Tooth (CMT) disease lack. Current treatments, such as ankle and foot surgery/orthoses, analgesics, and physiotherapy, focus on relieving the symptoms. Few randomized controlled trials (RCTs) investigated the effectiveness of exercise in patients with CMT, and a systematic review summarizing the effects of such treatments is outdated. This study aims to systematically review the effects of exercise on muscle strength, function, aerobic capacity, and quality of life in CMT. METHODS: We included RCTs that compared exercise programs against sham exercise, usual care, no exercise, and different exercise programs in individuals diagnosed with CMT. Searches were performed on 10 electronic databases from inception up to July 2021. Authors analyzed titles, abstracts, and full texts and extracted information from the eligible trials. We used the Physiotherapy Evidence Database (PEDro) scale and the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach to evaluate the risk of bias and the certainty of the evidence, respectively. Results were synthesized narratively. RESULTS: Eight citations (six studies; pooled n = 214) met the inclusion criteria. The mean age of participants was 38.49 (±13.02) years, and 83% were diagnosed with CMT1A. The mean PEDro score was 5.25 (range 2-9). Six trials were considered to have a high risk of bias. Moderate-quality evidence suggests that strengthening the ankle dorsiflexors minimizes the progression of weakness at 24 months in children with CMT1A. For other outcomes, quality of the evidence ranged from very low to low. INTERPRETATION: Based on the available, evidence we can only recommend exercise to improve muscle strength in children with CMT. More high quality and robust trials are needed.

Barriers to and facilitators of physical activity in adults living with and beyond cancer, with special emphasis on head and neck cancer: a systematic review of qualitative and mixed methods studies.

PURPOSE: Physical activity can improve health outcomes for cancer patients; however, only 30% of patients are physically active. This review explored barriers to and facilitators of physical activity promotion and participation in patients living with and beyond cancer. Secondary aims were to (1) explore similarities and differences in barriers and facilitators experienced in head and neck cancer versus other cancers, and (2) identify how many studies considered the influence of socioeconomic characteristics on physical activity behaviour. METHODS: CINAHL Plus, MEDLINE, PsycINFO, Scopus and Cochrane (CDSR) were searched for qualitative and mixed methods evidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool and a Critical Appraisal Skills Programme Tool. Thematic synthesis and frequency of reporting were conducted, and results were structured using the Capability-Opportunity-Motivation-Behaviour model and Theoretical Domains Framework. RESULTS: Thirty qualitative and six mixed methods studies were included. Socioeconomic characteristics were not frequently assessed across the included studies. Barriers included side effects and comorbidities (physical capability; skills) and lack of knowledge (psychological capability; knowledge). Having a dry mouth or throat and choking concerns were reported in head and neck cancer, but not across other cancers. Facilitators included improving education (psychological capability; knowledge) on the benefits and safety of physical activity. CONCLUSION: Educating patients and healthcare professionals on the benefits and safety of physical activity may facilitate promotion, uptakeand adherence. Head and neck cancer patients experienced barriers not cited across other cancers, and research exploring physical activity promotion in this patient group is required to improve physical activity engagement.

Leisure-time and occupational physical activity demonstrate divergent associations with periodontitis: A population-based study.

AIM: To evaluate the association between leisure-time/occupational physical activity (LTPA/OPA) and periodontitis in a nationally representative sample of the U.S. MATERIALS AND METHODS: Data from 10,679 adults were retrieved from NHANES 2009-2014 database. Physical activity was assessed through the Global Physical Activity Questionnaire, and accordingly, subjects were classified as performing either high or low LTPA/OPA. Periodontal status was assessed through a full-mouth periodontal examination, and subjects were classified according to the AAP/CDC criteria (no, mild, moderate, or severe periodontitis). Simple and multiple regression analyses were applied to study the association between LTPA/OPA and periodontitis/severe periodontitis. RESULTS: Multiple regression analyses identified high LTPA as a protective indicator for periodontitis (odds ratio [OR] = 0.81; 95% confidence interval [CI]: 0.72-0.92), while high OPA was found to be a significant risk indicator (OR = 1.16; 95% CI: 1.04-1.30). The combination low LTPA/high OPA showed a cumulative independent association with periodontitis (OR = 1.47; 95% CI: 1.26-1.72). Moreover, both high LTPA (OR = 0.72; 95% CI: 0.58-0.90) and high OPA (OR = 1.29; 95% CI: 1.09-1.53) were significantly associated with stronger estimates of severe periodontitis; the same was observed for the combination of low LTPA/high OPA (OR = 1.66; 95% CI: 1.29-2.15). CONCLUSIONS: LTPA and OPA showed divergent associations with periodontitis.

'A Different Ball Game': Adaptation of a men's health program for implementation in rural Australia.

BACKGROUND: Men residing in rural areas are less likely to participate in weight management interventions than women, and few men-specific programs target rural areas. Aussie-Fans in Training (Aussie-FIT) is an evidence-based weight management intervention that uses professional Australian Football club affiliations and settings as a 'hook' to engage urban-residing men. The aim of this study is to report on how findings from rural stakeholder focus groups were used to inform the adaptation of Aussie-FIT for implementation in rural areas. METHODS: Seven focus groups with stakeholders (n = 24) in three rural towns explored existing weight management and physical activity provisions, barriers and facilitators to engaging men, and considerations for adapting Aussie-FIT for implementation in rural contexts. Qualitative data were analysed using the framework approach. Adaptations made to the Aussie-FIT program and strategies to implement the program in rural contexts were reported using a structured framework. RESULTS: Themes generated from our analysis include limited appealing services for men, Australian Football as a 'common language', the influence of the 'smaller fishpond'(population), considerations for program inclusivity, and the importance of local partner organisations for sustainability. We adapted the recruitment and marketing strategies, delivery settings, football program theme and partnerships for rural implementation. Stakeholders advised that an Australian Football program theme without specific local club affiliations would be important to avoid alienating men with differing club allegiances or non-sporting backgrounds. A multi-component recruitment strategy utilising local trusted sources, and program marketing that aligns with masculine ideals were considered important by stakeholders in small communities where 'people talk'. CONCLUSIONS: Rural areas were described as 'a different ball game' due to limited local services and resources in comparison to metropolitan areas. Study findings have synergies with previous studies undertaken in rural contexts including in relation to the power of word of mouth, the importance of trust, and local partner organisations. Findings have implications for engaging rural men in health interventions in rural contexts where professional sporting contexts are not available. Assessing the extent to which the adapted Aussie-FIT program can reach and engage men in rural Australia, and exploring the barriers and facilitators to delivering the program in rural contexts is required.

The effect of acute exercise on the cortisol awakening response.

The effects of acute exercise on the cortisol awakening response (CAR), characterized by the rapid increase in cortisol concentrations within the 30-45 min following sleep offset has yet to be fully elucidated. Thus, our study investigated the effects of late-evening acute exercise on the CAR the following morning. We hypothesized that exercise would have a significant effect on the CAR the following morning. Twelve participants (mean (SD): age = 23 (4) years; mass = 76.8 (8.7) kg; height = 175.6 (5.0) cm; [Formula: see text]O2max = 48.9 (7.5) ml.kg-1.min-1) reported to the laboratory in the evening (1800 h) on two occasions and were randomly assigned to either exercise for one hour (70-75% of maximal power output) or rest condition. Blood and saliva samples were assayed for cortisol. Mixed-effects models determined the effect of exercise on the cortisol response post-waking in both blood and saliva. Participants demonstrated an average exercise-induced increase in circulating cortisol of 477.3%, with actual mean (SD) heart rate relative to maximum of 87.04% (6.14%). Model results demonstrated a negative effect for exercise condition when modeling the serum and salivary cortisol responses to awakening via a quadratic growth model (serum, ßCondition = - 42.26 [95% CI - 64.52 to - 20.01], p < 0.001; saliva, ßCondition = - 11.55 [95% CI - 15.52 to - 7.57], p < 0.001). These results suggest that cortisol concentrations in saliva and blood are significantly lower the morning following a prior evening exercise session. Therefore, the CAR may serve as a useful biomarker to monitor responses to exercise training, although the underlying mechanism for these decreases in the CAR should be investigated further.

Carbohydrate mouth rinse is no more effective than placebo on running endurance of dehydrated and heat acclimated athletes.

PURPOSE: To determine whether carbohydrate mouth rinsing would improve endurance running performance of tropical natives in a warm-humid (30 °C and 70% relative humidity) environment. METHOD: Twelve endurance male runners [age 25 ± 3 years; peak aerobic capacity ([Formula: see text]O2peak) 57.6 ± 3.6 mL.kg-1.min-1] completed three time-to-exhaustion (TTE) trials at ~ 70% [Formula: see text]O2peak while swilling 25 ml of a 6% carbohydrate (CHO) or taste-matched placebo (PLA) as well as no mouth rinse performed in the control (CON) trial. RESULTS: TTE performance was significantly longer in both CHO and PLA trials when compared with the CON trial (54.7 ± 5.4 and 53.6 ± 5.1 vs. 48.4 ± 3.6 min, respectively; p < 0.001 and p = 0.012, respectively), but was not significantly different between CHO and PLA trials (p = 1.000). The rating of perceived exertion was not different between the CHO and PLA trials, however, was significantly affected when compared to the CON trial (p < 0.001). A similar effect was observed for perceived arousal level between the CHO and PLA trials to the CON trial. Core temperature, mean skin temperature and skin blood flow were not significantly different between the three trials (all p > 0.05). Similarly, plasma lactate and glucose as well as exercise heart rate were not influenced by the trials. CONCLUSIONS: The present study demonstrates that mouth rinsing, whether carbohydrate or placebo, provides an ergogenic benefit to running endurance when compared to CON in a heat stress environment. Nevertheless, the results do not support the notion that rinsing a carbohydrate solution provides a greater advantage as previously described among non-heat acclimated individuals within a temperate condition.

Carbohydrate intake before and during high intensity exercise with reduced muscle glycogen availability affects the speed of muscle reoxygenation and performance.

Muscle glycogen state and carbohydrate (CHO) supplementation before and during exercise may impact responses to high-intensity interval training (HIIT). This study determined cardiorespiratory, substrate metabolism, muscle oxygenation, and performance when completing HIIT with or without CHO supplementation in a muscle glycogen depleted state. On two occasions, in a cross-over design, eight male cyclists performed a glycogen depletion protocol prior to HIIT during which either a 6% CHO drink (60 g.hr-1) or placebo (%CHO, PLA) was consumed. HIIT consisted of 5 × 2 min at 80% peak power output (PPO), 3 × 10-min bouts of steady-state (SS) cycling (50, 55, 60% PPO), and a time-to-exhaustion (TTE) test. There was no difference in SS [Formula: see text], HR, substrate oxidation and gross efficiency (GE %) between CHO and PLA conditions. A faster rate of muscle reoxygenation (%. s-1) existed in PLA after the 1st (Δ - 0.23 ± 0.22, d = 0.58, P < 0.05) and 3rd HIIT intervals (Δ - 0.34 ± 0.25, d = 1.02, P < 0.05). TTE was greater in CHO (7.1 ± 5.4 min) than PLA (2.5 ± 2.3 min, d = 0.98, P < 0.05). CHO consumption before and during exercise under reduced muscle glycogen conditions did not suppress fat oxidation, suggesting a strong regulatory role of muscle glycogen on substrate metabolism. However, CHO ingestion provided a performance benefit under intense exercise conditions commenced with reduced muscle glycogen. More research is needed to understand the significance of altered muscle oxygenation patterns during exercise.