The impact of moulage on learners' experience in simulation-based education and training: systematic review.

BACKGROUND: Moulage is a technique used to simulate injury, disease, aging and other physical characteristics specific to a scenario, often used in health and emergency worker training, predominantly for simulation-based learning activities. Its use in allied health fields is unclear. Previous work has explored moulage as an adjunct for authentic simulations, however there is opportunity for broadening its scope. AIM: To explore the effects of moulage interventions in simulation-based education and training, for learner experience. A secondary aim was to understand which pedagogical frameworks were embedded in moulage interventions. METHOD: Four electronic databases (PubMed, CINAHL, EmBase, Proquest Central) were systematically searched to December 2022 for studies utilising moulage in simulation-based education experiences. Outcomes were focused on learner satisfaction, confidence, immersion, engagement, performance, or knowledge. Study quality was assessed using the Mixed Methods Appraisal Tool. RESULTS: Twenty studies (n = 11,470) were included. Studies were primarily conducted in medicine (n = 9 studies) and nursing (n = 5 studies) and less frequently across other health disciplines. The findings demonstrated greater learner satisfaction, confidence, and immersion when moulage was used against a comparator group. Minimal improvements in knowledge and performance were identified. One study underpinned the intervention with a pedagogical theory. CONCLUSION: Moulage improves learner experience in simulation-based education or training, but not knowledge or clinical performance. Further research utilising moulage across a broader range of professions is needed. Interventions using moulage should be underpinned by pedagogical theories.

Fluid intake is a strong predictor of outdoor team sport pre-season training performance.

Our aim was to characterize fluid intake during outdoor team sport training and use generalized additive models to quantify interactions with the environment and performance. Fluid intake, body mass (BM) and internal/external training load data were recorded for male rugby union (n = 19) and soccer (n = 19) athletes before/after field training sessions throughout an 11-week preseason (357 observations). Running performance (GPS) and environmental conditions were recorded each session and generalized additive models were applied in the analysis of data. Mean body mass loss throughout all training sessions was -1.11 ± 0.63 kg (~1.3%) compared with a mean fluid intake at each session of 958 ± 476 mL during the experimental period. For sessions >110 min, when fluid intake reached ~10-19 mL·kg-1 BM the total distance increased (7.47 to 8.06 km, 7.6%; P = 0.049). Fluid intake above ~10 mL·kg-1 BM was associated with a 4.1% increase in high-speed running distance (P < 0.0001). Most outdoor team sport athletes fail to match fluid loss during training, and fluid intake is a strong predictor of running performance. Improved hydration practices during training should be beneficial and we provide a practical ingestion range to promote improved exercise capacity in outdoor team sport training sessions.

The Use of Continuous Glucose Monitors in Sport: Possible Applications and Considerations.

This review discusses the potential value of tracking interstitial glucose with continuous glucose monitors (CGMs) in athletes, highlighting possible applications and important considerations in the collection and interpretation of interstitial glucose data. CGMs are sensors that provide real time, longitudinal tracking of interstitial glucose with a range of commercial monitors currently available. Recent advancements in CGM technology have led to the development of athlete-specific devices targeting glucose monitoring in sport. Although largely untested, the capacity of CGMs to capture the duration, magnitude, and frequency of interstitial glucose fluctuations every 1-15 min may present a unique opportunity to monitor fueling adequacy around competitive events and training sessions, with applications for applied research and sports nutrition practice. Indeed, manufacturers of athlete-specific devices market these products as a "fueling gauge," enabling athletes to "push their limits longer and get bigger gains." However, as glucose homeostasis is a complex phenomenon, extensive research is required to ascertain whether systemic glucose availability (estimated by CGM-derived interstitial glucose) has any meaning in relation to the intended purposes in sport. Whether CGMs will provide reliable and accurate information and enhance sports nutrition knowledge and practice is currently untested. Caveats around the use of CGMs include technical issues (dislodging of sensors during periods of surveillance, loss of data due to synchronization issues), practical issues (potential bans on their use in some sporting scenarios, expense), and challenges to the underpinning principles of data interpretation, which highlight the role of sports nutrition professionals to provide context and interpretation.

The effectiveness of nutrition education programmes on improving dietary intake in athletes: a systematic review.

Nutrition education programmes for athletes aim to enhance nutrition knowledge and more importantly support positive dietary change to enhance performance, health and well-being. This systematic review assessed changes in the dietary intakes of athletes in response to nutrition education programmes. A search was conducted which included studies providing quantitative dietary intake assessment of athletes of any calibre aged between 12 and 65 years in response to a nutrition education programme. Standardised differences (effect sizes) were calculated (when possible) for each dietary parameter. The search yielded 6285 papers with twenty-two studies (974 participants (71·9 % female)) eligible for inclusion. Studies described athletes competing at high school (n 3) through to college level or higher (n 19). Study designs were either single arm with an intervention-only group (twelve studies; n 241) or double arm including an intervention and control group (ten studies; n 689). No control groups received an alternative or 'sham' intervention. Face-to-face lectures (9/22) and individual nutrition counselling (6/22) were the most common education interventions. Non-weighed, 3-d diet records (10/22) were the most frequently utilised dietary assessment method. Although 14/22 studies (n 5 single and n 9 double) reported significant change in at least one nutrition parameter, dietary changes were inconsistent. Poor study quality and heterogeneity of methods prohibit firm conclusions regarding overall intervention success or superior types of educational modalities. Of note, carbohydrate intakes 'post-intervention' when assessed often failed to meet recommended guidelines (12/17 studies). Given the substantial investment made in nutrition education interventions with athletes, there is a need for well-designed and rigorous research to inform future best practice.

Belief in caffeine's ergogenic effect on cognitive function and endurance performance: A sham dose-response study.

This study aimed to determine if belief in caffeine's ergogenic potential influences choice reaction time (CRT) and/or running performance. Twenty-nine healthy individuals (23.7 ± 5 years, 16 males) completed two trials (one week apart). Before the trials, participants indicated their "belief" in caffeine's ergogenic effects and previous "experience" using caffeine for performance. On arrival, participants randomly received either sham "Low (100mg; LD)" or "High (300mg; HD)" dose caffeine capsules 30-min before commencing the CRT test, followed by a 10km run. Paired samples t-tests determined differences between trials for CRT latency (Ex-Gaussian analysis; µ-, σ- and τ-) and running performance using the entire cohort and sub-groups exhibiting strong "beliefs"+/-"experience". Sham caffeine dose did not influence CRT (µ-, σ- and τ-respectively, LD: 400 ± 53ms vs. HD: 388 ± 41ms; LD: 35 ± 18ms vs. HD: 34 ± 17ms; LD: 50 ± 24ms vs. HD: 52 ± 19ms, all p's > 0.05). Neither belief (n = 6), nor belief + experience (n = 4), influenced this effect. Furthermore, caffeine dose did not influence run time (LD: 49.05 ± 3.75min vs. HD: 49.06 ± 3.85min, p = 0.979). Belief (n = 9) (LD: 48.93 ± 3.71min vs. HD: 48.9 ± 3.52min, p = 0.976), and belief + experience (n = 6) (LD: 48.68 ± 1.87min vs. HD: 49.55 ± 1.75min, p = 0.386) didn't influence this effect. A dose-response to sham caffeine ingestion was not evident on cognitive or endurance performance in healthy individuals, regardless of their convictions about caffeine's ergogenicity.

Consumer expectation and responses to environmental sustainability initiatives and their impact in foodservice operations: A systematic review.

BACKGROUND: With increasing pressure on the Earth's finite resources, there is significant demand for environmentally sustainable practices in foodservice. A shift to sustainable foodservice operations can decrease its environmental impact and may align with consumer expectations. This systematic review explored consumer expectations (attitudes pre-intervention) and responses (behaviour, cognitive attitudes and affective attitudes post-intervention) towards environmentally sustainable initiatives of foodservice operations. METHODS: A systematic search following PRISMA guidelines was conducted across MEDLINE, EMABASE, CINAHL and Web of Science databases. English and full-text research articles published up to November 2019 were identified. Consumers' expectations and responses to interventions were extracted. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Thirty-three studies were included and, given the heterogeneity of the studies, the results were synthesised narratively. The main outcomes analysed included changes in behaviour and attitudes (cognitive and affective), including knowledge and satisfaction. Intervention strategies were interpreted and categorised into three groups: food waste reduction, single-use item and packaging waste reduction, and initiatives related to menu, messaging and labelling. Most studies resulted in significant pro-environmental changes towards decreasing food waste, decreasing single use-item and packaging waste, as well as engaging consumers in sustainable eating. CONCLUSIONS: There are a range of successful environmentally sustainable strategies that when implemented by foodservices can have a mostly positive impact on consumer attitudes and responses. However, positive consumer attitudes did not always translate to changes in behaviour. Foodservices should carefully consider implementing interventions that support changes in consumer behaviour.

Do multi-ingredient protein supplements augment resistance training-induced gains in skeletal muscle mass and strength? A systematic review and meta-analysis of 35 trials.

OBJECTIVE: To determine the effects of multi-ingredient protein (MIP) supplements on resistance exercise training (RT)-induced gains in muscle mass and strength compared with protein-only (PRO) or placebo supplementation. DATA SOURCES: Systematic search of MEDLINE, Embase, CINAHL and SPORTDiscus. ELIGIBILITY CRITERIA: Randomised controlled trials with interventions including RT ≥6 weeks in duration and a MIP supplement. DESIGN: Random effects meta-analyses were conducted to determine the effect of supplementation on fat-free mass (FFM), fat mass, one-repetition maximum (1RM) upper body and 1RM lower body muscular strength. Subgroup analyses compared the efficacy of MIP supplementation relative to training status and chronological age. RESULTS: The most common MIP supplements included protein with creatine (n=17) or vitamin D (n=10). Data from 35 trials with 1387 participants showed significant (p<0.05) increases in FFM (0.80 kg (95% CI 0.44 to 1.15)), 1RM lower body (4.22 kg (95% CI 0.79 to 7.64)) and 1RM upper body (2.56 kg (95% CI 0.79 to 4.33)) where a supplement was compared with all non-MIP supplemented conditions (means (95% CI)). Subgroup analyses indicated a greater effect of MIP supplements compared with all non-MIP supplements on FFM in untrained (0.95 kg (95% CI 0.51 to 1.39), p<0.0001) and older participants (0.77 kg (95% CI 0.11 to 1.43), p=0.02); taking MIP supplements was also associated with gains in 1RM upper body (1.56 kg (95% CI 0.80 to 2.33), p=0.01) in older adults. SUMMARY/CONCLUSIONS: When MIP supplements were combined with resistance exercise training, there were greater gains in FFM and strength in healthy adults than in counterparts who were supplemented with non-MIP. MIP supplements were not superior when directly compared with PRO supplements. The magnitude of effect of MIP supplements was greater (in absolute values) in untrained and elderly individuals undertaking RT than it was in trained individuals and in younger people. TRIAL REGISTRATION NUMBER: CRD42017081970.

Effect of Drinking Rate on the Retention of Water or Milk Following Exercise-Induced Dehydration.

This study investigated the effect of drinking rate on fluid retention of milk and water following exercise-induced dehydration. In Part A, 12 male participants lost 1.9% ± 0.3% body mass through cycle exercise on four occasions. Following exercise, plain water or low-fat milk equal to the volume of sweat lost during exercise was provided. Beverages were ingested over 30 or 90 min, resulting in four beverage treatments: water 30 min, water 90 min, milk 30 min, and milk 90 min. In Part B, 12 participants (nine males and three females) lost 2.0% ± 0.3% body mass through cycle exercise on four occasions. Following exercise, plain water equal to the volume of sweat lost during exercise was provided. Water was ingested over 15 min (DR15), 45 min (DR45), or 90 min (DR90), with either DR15 or DR45 repeated. In both trials, nude body mass, urine volume, urine specific gravity and osmolality, plasma osmolality, and subjective ratings of gastrointestinal symptoms were obtained preexercise and every hour for 3 hr after the onset of drinking. In Part A, no effect of drinking rate was observed on the proportion of fluid retained, but milk retention was greater (p < .01) than water (water 30 min: 57% ± 16%, water 90 min: 60% ± 20%, milk 30 min: 83% ± 6%, and milk 90 min: 85% ± 7%). In Part B, fluid retention was greater in DR90 (57% ± 13%) than DR15 (50% ± 11%, p < .05), but this was within test-retest variation determined from the repeated trials (coefficient of variation: 17%). Within the range of drinking rates investigated the nutrient composition of a beverage has a more pronounced impact on fluid retention than the ingestion rate.

Influence of Periodizing Dietary Carbohydrate on Iron Regulation and Immune Function in Elite Triathletes.

Sleeping with low carbohydrate (CHO) availability is a dietary strategy that may enhance training adaptation. However, the impact on an athlete's health is unclear. This study quantified the effect of a short-term "sleep-low" dietary intervention on markers of iron regulation and immune function in athletes. In a randomized, repeated-measures design, 11 elite triathletes completed two 4-day mixed cycle run training blocks. Key training sessions were structured such that a high-intensity training session was performed in the field on the afternoon of Days 1 and 3, and a low-intensity training (LIT) session was performed on the following morning in the laboratory (Days 2 and 4). The ingestion of CHO was either divided evenly across the day (HIGH) or restricted between the high-intensity training and LIT sessions, so that the LIT session was performed with low CHO availability (LOW). Venous blood and saliva samples were collected prior to and following each LIT session and analyzed for interleukin-6, hepcidin 25, and salivary immunoglobulin-A. Concentrations of interleukin-6 increased acutely after exercise (p < .001), but did not differ between dietary conditions or days. Hepcidin 25 increased 3-hr postexercise (p < .001), with the greatest increase evident after the LOW trial on Day 2 (2.5 ± 0.9 fold increase ±90% confidence limit). The salivary immunoglobulin-A secretion rate did not change in response to exercise; however, it was highest during the LOW condition on Day 4 (p = .046). There appears to be minimal impact to markers of immune function and iron regulation when acute exposure to low CHO availability is undertaken with expert nutrition and coaching input.

Sports Dietitians Australia Position Statement: Nutrition for Exercise in Hot Environments.

It is the position of Sports Dietitians Australia (SDA) that exercise in hot and/or humid environments, or with significant clothing and/or equipment that prevents body heat loss (i.e., exertional heat stress), provides significant challenges to an athlete's nutritional status, health, and performance. Exertional heat stress, especially when prolonged, can perturb thermoregulatory, cardiovascular, and gastrointestinal systems. Heat acclimation or acclimatization provides beneficial adaptations and should be undertaken where possible. Athletes should aim to begin exercise euhydrated. Furthermore, preexercise hyperhydration may be desirable in some scenarios and can be achieved through acute sodium or glycerol loading protocols. The assessment of fluid balance during exercise, together with gastrointestinal tolerance to fluid intake, and the appropriateness of thirst responses provide valuable information to inform fluid replacement strategies that should be integrated with event fuel requirements. Such strategies should also consider fluid availability and opportunities to drink, to prevent significant under- or overconsumption during exercise. Postexercise beverage choices can be influenced by the required timeframe for return to euhydration and co-ingestion of meals and snacks. Ingested beverage temperature can influence core temperature, with cold/icy beverages of potential use before and during exertional heat stress, while use of menthol can alter thermal sensation. Practical challenges in supporting athletes in teams and traveling for competition require careful planning. Finally, specific athletic population groups have unique nutritional needs in the context of exertional heat stress (i.e., youth, endurance/ultra-endurance athletes, and para-sport athletes), and specific adjustments to nutrition strategies should be made for these population groups.

Impact of 3-day high and low dietary sodium intake on sodium status in response to exertional-heat stress: a double-blind randomized control trial.

PURPOSE: To determine the impact of altering dietary sodium intake for 3 days preceding exercise on sweat sodium concentration [Na+], and cardiovascular and thermoregulatory variables. METHODS: Fifteen male endurance athletes (runners n = 8, cyclists n = 7) consumed a low (LNa, 15 mg kg-1 day-1) or high (HNa, 100 mg kg-1 day-1) sodium diet, or their usual free-living diet [UDiet, 46 (37-56) mg kg-1 day-1] for 3 days in a double-blind, randomized cross-over design, collecting excreted urine (UNa) and refraining from exercise. On day 4, they completed 2 h running at 55% [Formula: see text]O2max or cycling at 55% maximum aerobic power in Tamb 35 °C. Pre- and post-exercise blood samples were collected, and sweat from five sites using absorbent patches along the exercise protocol. RESULTS: UNa on days 2-3 pre-exercise [mean (95% CI) LNa 16 (12-19) mg kg-1 day-1, UDiet 46 (37-56) mg kg-1 day-1, HNa 79 (72-85) mg kg-1 day-1; p < 0.001] and pre-exercise aldosterone [LNa 240 (193-286) mg kg-1 day-1, UDiet 170 (116-224) mg kg-1 day-1, HNa 141 (111-171) mg kg-1 day-1; p = 0.001] reflected sodium intake as expected. Pre-exercise total body water was greater following HNa compared to LNa (p < 0.05), but not UDiet. Estimated whole-body sweat [Na+] following UDiet was 10-11% higher than LNa and 10-12% lower than HNa (p < 0.001), and correlated with pre-exercise aldosterone (1st h r = - 0.568, 2nd h r = - 0.675; p < 0.01). Rectal temperature rose more quickly in LNa vs HNa (40-70 min; p < 0.05), but was similar at the conclusion of exercise, and no significant differences in heart rate or perceived exertion were observed. CONCLUSIONS: Three day altered sodium intake influenced urinary sodium excretion and sweat [Na+], and the rise in rectal temperature, but had no effect on perceived exertion during moderate-intensity exercise in hot ambient conditions.

Iron considerations for the athlete: a narrative review.

Iron plays a significant role in the body, and is specifically important to athletes, since it is a dominant feature in processes such as oxygen transport and energy metabolism. Despite its importance, athlete populations, especially females and endurance athletes, are commonly diagnosed with iron deficiency, suggesting an association between sport performance and iron regulation. Although iron deficiency is most common in female athletes (~ 15-35% athlete cohorts deficient), approximately 5-11% of male athlete cohorts also present with this issue. Furthermore, interest has grown in the mechanisms that influence iron absorption in athletes over the last decade, with the link between iron regulation and exercise becoming a research focus. Specifically, exercise-induced increases in the master iron regulatory hormone, hepcidin, has been highlighted as a contributing factor towards altered iron metabolism in athletes. To date, a plethora of research has been conducted, including investigation into the impact that sex hormones, diet (e.g. macronutrient manipulation), training and environmental stress (e.g. hypoxia due to altitude training) have on an athlete's iron status, with numerous recommendations proposed for consideration. This review summarises the current state of research with respect to the aforementioned factors, drawing conclusions and recommendations for future work.

The effect of beetroot juice supplementation on repeat-sprint performance in hypoxia.

This investigation assessed the effect of dietary nitrate (NO3-) supplementation, in the form of beetroot juice (BR), on repeat-sprint performance in normoxia and normobaric hypoxia. 12 male team-sport athletes (age 22.3 ± 2.6 y, VO2peak 53.1 ± 8.7 mL.kg-1.min-1) completed three exercise trials involving a 10 min submaximal warm-up and 4 sets of cycling repeat-sprint efforts (RSE; 9 × 4 s) at sea level (CON), or at 3000 m simulated altitude following acute supplementation (140 mL) with BR (HYPBR; 13 mmol NO3-) or NO3-depleted BR placebo (HYPPLA). Peak (PPO) and mean (MPO) power output, plus work decrement were recorded during the RSE task, while oxygen consumption (VO2) was measured during the warm-up. There were no significant differences observed between HYPBR and HYPPLA for PPO or MPO; however, work decrement was reduced in the first RSE set in HYPBR compared with HYPPLA. There was a moderate effect for VO2 to be lower following BR at the end of the 10 min warm-up (ES = 0.50 ± 0.51). Dietary NO3- may not improve repeat-sprint performance in hypoxia but may reduce VO2 during submaximal exercise. Therefore, BR supplementation may be more effective for performance improvement during predominantly aerobic exercise.

Sodium Intake Beliefs, Information Sources, and Intended Practices of Endurance Athletes Before and During Exercise.

There is little information describing how endurance athletes perceive sodium intake in relation to training and competition. Using an online questionnaire, this study assessed the beliefs, information sources, and intended practices regarding sodium ingestion for training and competition. Endurance athletes (n = 344) from six English-speaking countries completed the questionnaire and were included for analysis. The most cited information sources were social supports (63%), self-experimentation (56%), and media (48%). Respondents generally believed (>50% on electronic visual analog scale) endurance athletes require additional sodium on a daily basis (median 67% [interquartile range: 40-81%]), benefit from increased sodium in the days preceding competition (60% [30-77%]), should replace sodium losses during training (69% [48-83%]) and competition (74% [54-87%]), and would benefit from sweat composition testing (82% [65-95%]). Respondents generally believed sodium ingestion during endurance exercise prevents exercise-associated muscle cramps (75% [60-88%]) and exercise-associated hyponatremia (74% [62-89%]). The majority (58%) planned to consciously increase sodium or total food intake (i.e., indirectly increasing sodium intake) in the days preceding competition. Most (79%) were conscious of sodium intake during competition, but only 29% could articulate a specific intake plan. A small minority (5%) reported using commercial sweat testing services, of which 75% believed it was beneficial. We conclude that endurance athletes commonly perceive sodium intake as important for their sporting activities. Many intend to consciously increase sodium intake in the days preceding and during competition, although these views appear informed mostly by nonscientific and/or non-evidence-based sources.

Calorie-Containing Recovery Drinks Increase Recreational Runners' Voluntary Energy and Carbohydrate Intake, with Minimal Impact on Fluid Recovery.

This study assessed voluntary dietary intake when different beverages were provided within a recovery area following recreational exercise. Participants completed two 10-km runs 1 week apart. Immediately after the first run, "beer drinkers" (n = 54; mean ± SD: age = 23.9 ± 5.8 years, body mass [BM] = 76 ± 13 kg) randomly received low-alcohol beer (Hahn Ultra® [Lion Co.], 0.9% alcohol by volume) or sports drink (SD; Gatorade® [PepsiCo]), whereas "nonbeer drinkers" (n = 78; age = 21.8 ± 2.2 years, BM = 71 ± 13 kg) received water or SD. Participants remained in a recovery area for 30-60 min with fluid consumption monitored. The following week, participants received the alternate beverage. Participants recorded all food/fluid consumed for the remainder of both trial days (diary and photographs). Fluid balance was assessed via BM change and urine specific gravity. Paired t tests were used to assess differences in hydration and dietary variables. No differences were observed in preexercise urine specific gravity (∼1.01) or BM loss (∼2%) between intervention groups (ps > .05). Water versus SD: No difference in acute fluid intake was noted (water = 751 ± 259 ml, SD = 805 ± 308 ml, p = .157). SD availability influenced total energy and carbohydrate intakes (water = 5.7 ± 2.5 MJ and 151 ± 77 g, SD = 6.5 ± 2.7 MJ and 187 ± 87 g, energy p = .002, carbohydrate p < .001). SD versus beer: SD availability resulted in greater acute fluid intake (SD = 1,047 ± 393 ml, beer = 850 ± 630 ml; p = .004), which remained evident at the end of trial days (SD = 3,337 ± 1,100 ml, beer = 2,982 ± 1,191 ml; p < .01). No differences in dietary variables were observed. Next day, urine specific gravity values were not different between water versus SD. However, a small difference was detected between SD versus beer (SD = 1.021 ± 0.009, beer = 1.016 ± 0.008, p = .002). Consuming calorie-containing drinks postexercise appears to increase daily energy and carbohydrate intake but has minimal impact on next-day hydration.

Effect of dietary nitrate supplementation on thermoregulatory and cardiovascular responses to submaximal cycling in the heat.

PURPOSE: This study investigated whether reported improvements in blood flow distribution, and the possible related effects on thermoregulation during exercise following supplementation with beetroot juice (BR), a rich source of dietary nitrate (NO3-), are mitigated in the heat. METHODS: 12 male endurance-trained cyclists (age 27 ± 6 years, VO2peak 68.6 ± 8.1 ml kg-1 min-1) completed two 60 min submaximal cycling trials at 60% of VO2peak power output. Trials were performed in hot environmental conditions (33.3 ± 0.4 °C, 48.8 ± 3.0% RH) following 3 days of supplementation with either NO3--rich BR (6.5 mmol NO3- for 2 days and 13 mmol NO3- on the final day) or NO3--depleted placebo (PLA). Salivary NO3- and nitrite (NO2-) were measured before and after the supplementation period. During exercise, cutaneous blood flow, blood pressure (MAP), core temperature (Tc), mean skin temperature (Tsk), indices of muscle oxygenation and oxygen (O2) consumption were measured. RESULTS: Salivary NO3- and NO2- increased significantly following BR by 680 and 890%, respectively. There were no significant differences observed for cutaneous blood flow, MAP, Tc, Tsk, muscle oxygenation, or O2 consumption between BR and PLA. CONCLUSION: This investigation shows that the ergogenic effects and health benefits of BR supplementation, such as augmented cutaneous blood flow, reduced MAP, increased muscle oxygenation, and improved aerobic efficiency may be attenuated when exercise is performed in hot conditions.

Effects of acute exercise, dehydration and rehydration on cognitive function in well-trained athletes.

This study investigated the effects of aerobic exercise, fluid loss and rehydration on cognitive performance in well-trained athletes. Ten endurance-trained males (25 ± 5 years; 175 ± 5 cm; 70.35 ± 5.46 kg; VO2max, 62.95 ± 7.20 ml · kg.min-1) lost ~2.5 ± 0.6% body mass via continuous cycling exercise at ~65% peak sustainable power output (60 min duration) before consuming different beverages (Water = W1 and W2, Sustagen Sport = SS, Powerade = PD) and food ad libitum on four separate occasions. Cognitive function using a four-choice reaction time task (CRT), body mass, fluid consumption volumes, urine samples and subjective ratings (alertness, concentration, energy) were obtained before and after exercise, and hourly during recovery (for 4 h). CRT latency was significantly reduced immediately after exercise compared to pre-exercise measures for all trials (W1 = -16 ± 18 ms, W2 = -22 ± 21 ms, PD = -22 ± 22 ms, SS = -19 ± 26 ms). However, this effect was short-lived with subsequent measures not different from pre-exercise values. No difference in CRT accuracy was observed at any time across all trials. Subjective ratings were not different at any time across all trials. Aerobic exercise, hypohydration or an interaction between these two may provide a small cognitive performance benefit. However, these effects are temporary and confined to the immediate post-exercise period.

Dietary nitrate supplementation does not improve cycling time-trial performance in the heat.

This investigation examined the effect of beetroot juice (BR) supplementation, a source of dietary nitrate (NO3-), on cycling time-trial (TT) performance and thermoregulation in the heat. In a double-blind, repeated-measures design, 12 male cyclists (age 26.6 ± 4.4 years, VO2peak 65.8 ± 5.5 mL.kg-1.min-1) completed four cycling TTs (14 kJ.kg-1) in hot (35°C, 48% relative humidity) and euthermic (21°C, 52%) conditions, following 3 days supplementation with BR (6.5 mmol NO3- for 2 days and 13 mmol NO3- on the final day), or NO3-depleted placebo (PLA). Salivary NO3- and nitrite, core (Tc) and mean skin temperature (Tsk) were measured. Salivary NO3- and nitrite increased significantly post-BR supplementation (p < 0.001). Average TT completion time (mm:ss) in hot conditions was 56:50 ± 05:08 with BR, compared with 58:30 ± 04:48 with PLA (p = 0.178). In euthermic conditions, average completion time was 53:09 ± 04:35 with BR, compared with 54:01 ± 04:05 with PLA (p = 0.380). The TT performance decreased (p < 0.001), and Tc (p < 0.001) and Tsk (p < 0.001) were higher in hot compared with euthermic conditions. In summary, BR supplementation has no significant effect on cycling TT performance in the heat.

The Effect of Water Loading on Acute Weight Loss Following Fluid Restriction in Combat Sports Athletes.

Novel methods of acute weight loss practiced by combat sport athletes include "water loading," the consumption of large fluid volumes for several days prior to restriction. We examined claims that this technique increases total body water losses, while also assessing the risk of hyponatremia. Male athletes were separated into control (n = 10) and water loading (n = 11) groups and fed a standardized energy-matched diet for 6 days. Days 1-3 fluid intake was 40 and 100 ml/kg for control and water loading groups, respectively, with both groups consuming 15 ml/kg on Day 4 and following the same rehydration protocol on Days 5 and 6. We tracked body mass (BM), urine sodium, urine specific gravity and volume, training-related sweat losses and blood concentrations of renal hormones, and urea and electrolytes throughout. Physical performance was assessed preintervention and postintervention. Following fluid restriction, there were substantial differences between groups in the ratio of fluid input/output (39%, p < .01, effect size = 1.2) and BM loss (0.6% BM, p = .02, effect size = 0.82). Changes in urine specific gravity, urea and electrolytes, and renal hormones occurred over time (p < .05), with an interaction of time and intervention on blood sodium, potassium, chloride, urea, creatinine, urine specific gravity, and vasopressin (p < .05). Measurements of urea and electrolyte remained within reference ranges, and no differences in physical performance were detected over time or between groups. Water loading appears to be a safe and effective method of acute BM loss under the conditions of this study. Vasopressin-regulated changes in aquaporin channels may potentially partially explain the mechanism of increased body water loss with water loading.

The Effect of Higher Than Recommended Protein Feedings Post-Exercise on Recovery Following Downhill Running in Masters Triathletes.

Following exercise-induced muscle damage (EIMD), masters athletes take longer to recover than younger athletes. The purpose of this study was to determine the effect of higher than recommended postexercise protein feedings on the recovery of knee extensor peak isometric torque (PIT), perceptions of recovery, and cycling time trial (TT) performance following EIMD in masters triathletes. Eight masters triathletes (52 ± 2 y, V̇O2max, 51.8 ± 4.2 ml•kg-1•min-1) completed two trials separated by seven days in a randomized, doubleblind, crossover study. Trials consisted of morning PIT testing and a 30-min downhill run followed by an eight-hour recovery. During recovery, a moderate (MPI; 0.3 g•kg-1•bolus-1) or high (0.6 g•kg-1•bolus-1) protein intake (HPI) was consumed in three bolus feedings at two hour intervals commencing immediately postexercise. PIT testing and a 7 kJ•kg-1 cycling TT were completed postintervention. Perceptions of recovery were assessed pre- and postexercise. The HPI did not significantly improve recovery compared with MPI (p > .05). However, comparison of within-treatment change shows the HPI provided a moderate beneficial effect (d = 0.66), attenuating the loss of afternoon PIT (-3.6%, d = 0.09) compared with the MPI (-8.6%, d = 0.24). The HPI provided a large beneficial effect (d = 0.83), reducing perceived fatigue over the eight-hour recovery (d = 1.25) compared with the MPI (d = 0.22). Despite these effects, cycling performance was unchanged (HPI = 2395 ± 297 s vs. MPI = 2369 ± 278 s; d = 0.09). In conclusion, doubling the recommended postexercise protein intake did not significantly improve recovery in masters athletes; however, HPI provided moderate to large beneficial effects on recovery that may be meaningful following EIMD.