Does Caffeine Increase Fat Metabolism? A Systematic Review and Meta-Analysis.

Whether caffeine (CAF) increases fat metabolism remains debatable. Using systematic review coupled with meta-analysis, our aim was to determine effects of CAF on fat metabolism and the relevant factors moderating this effect. Electronic databases PubMed, SPORTDiscus, and Web of Science were searched using the following string: CAF AND (fat OR lipid) AND (metabolism OR oxidation). A meta-analytic approach aggregated data from 94 studies examining CAF's effect on fat metabolism assessed by different biomarkers. The overall effect size (ES) was 0.39 (95% confidence interval [CI] [0.30, 0.47], p < .001), indicating a small effect of CAF to increase fat metabolism; however, ES was significantly higher (p < .001) based on blood biomarkers (e.g., free fatty acids, glycerol) (ES = 0.55, 95% CI [0.43, 0.67]) versus expired gas analysis (respiratory exchange ratio, calculated fat oxidation) (ES = 0.26, 95% CI [0.16, 0.37]), although both were greater than zero. Fat metabolism increased to a greater extent (p = .02) during rest (ES = 0.51, 95% CI [0.41, 0.62]) versus exercise (ES = 0.35, 95% CI [0.26, 0.44]) across all studies, although ES was not different for studies reporting both conditions (ES = 0.49 and 0.44, respectively). There were no subgroup differences based on participants' fitness level, sex, or CAF dosage. CAF ingestion increases fat metabolism but is more consistent with blood biomarkers versus whole-body gas exchange measures. CAF has a small effect during rest across all studies, although similar to exercise when compared within the same study. CAF dosage did not moderate this effect.

Small Beneficial Effect of Caffeinated Energy Drink Ingestion on Strength.

Collier, NB, Hardy, MA, Millard-Stafford, ML, and Warren, GL. Small beneficial effect of caffeinated energy drink ingestion on strength. J Strength Cond Res 30(7): 1862-1870, 2016-Because caffeine ingestion has been found to increase muscle strength, our aim was to determine whether caffeine when combined with other potential ergogenic ingredients, such as those in commercial energy drinks, would have a similar effect. Fifteen young healthy subjects were used in a double-blind, repeated-measures experimental design. Each subject performed 3 trials, ingesting either a caffeinated energy drink, an uncaffeinated version of the drink, or a placebo drink. The interpolated twitch procedure was used to assess maximum voluntary isometric contraction (MVIC) strength, electrically evoked strength, and percent muscle activation during MVIC of the knee extensors both before and after drink ingestion, and after a fatiguing bout of contractions; electromyographic (EMG) amplitude of the knee extensors during MVIC was also assessed. The mean (±SE) change in MVIC strength from before to after drink ingestion was significantly greater for the caffeinated energy drink compared with placebo [+5.0 (±1.7) vs. -0.5 (±1.5)%] and the difference between the drinks remained after fatigue (p = 0.015); the strength changes for the uncaffeinated energy drink were not significantly different from those of the other 2 drinks at any time. There was no significant effect of drink type on the changes in electrically evoked strength, percent muscle activation, and EMG from before to after drink ingestion. This study indicates that a caffeinated energy drink can increase MVIC strength but the effect is modest and the strength increase cannot be attributed to increased muscle activation. Whether the efficacy of energy drinks can be attributed solely to caffeine remains unclear.

Biological variation of plasma osmolality obtained with capillary versus venous blood.

BACKGROUND: Plasma osmolality (POsm) is a gold standard to assess hydration status but requires venipuncture. POsm obtained by lancing a digit, a source of capillary puncture blood (CAP), has not been validated. This study compared POsm from CAP versus venous blood (VEN) and validated its sensitivity to detect dehydration. METHODS: Healthy young adults (Study A: n=20 men, 22 women; Study B: n=23 men, 23 women) participated. In Study A, CAP and VEN were compared under controlled euhydration meeting dietary reference intakes for water (3.7 L men, 2.7 L women). In Study B, CAP was assessed for sensitivity to detect dehydration with receiver operating characteristic analysis over two 24 h periods: euhydration for 24 h followed by water restriction over 24 h. POsm was measured using freezing point depression. RESULTS: For all subjects, CAP POsm (283.0±3.9 mOsm/kg) was not significantly different (p=0.07) from VEN (284.2±3.5) during euhydration and met analytical goals for individuality and heterogeneity. When outliers (n=3) were eliminated, mean difference was -1.6 (±3.2) lower (p<0.01) with CAP. Fluid restriction increased (p<0.001) CAP POsm (284.0±4.4 to 292.8±5.2 mOsm/kg), achieving excellent accuracy (0.92) and sensitivity (89.1%) to predict mild dehydration (2% body mass loss). CONCLUSIONS: POsm via CAP exhibited similar coefficients of variation and analytical goals compared to VEN combined with excellent accuracy and sensitivity to detect dehydration. Although CAP values were approximately 2 mOsm/kg lower than VEN, CAP appears an adequate substitute for tracking changes in non-clinical settings.

Fluid Replacement Attenuates Physiological Strain Resulting From Mild Hypohydration Without Impacting Cognitive Performance.

PURPOSE: The impact of mild hypohydration on physiological responses and cognitive performance following exercise-heat stress (EHS) were examined compared with conditions when fluids were ingested ad libitum (AL) or replaced to match sweat losses (FR). METHODS: Twelve unacclimatized, recreationally-active men (22.2 ± 2.4 y) completed 50 min cycling (60%VO2peak) in the heat (32°C; 65% RH) under three conditions: no fluid (NF), AL, and FR. Before and after EHS, a cognitive battery was completed: Trail making, perceptual vigilance, pattern comparison, match-to-sample, and letter-digit recognition tests. RESULTS: Hypohydration during NF was greater compared with AL and FR (NF: -1.5 ± 0.6; AL: -0.3 ± 0.8; FR: -0.1 ± 0.3% body mass loss) resulting in higher core temperature (by 0.4, 0.5 °C), heart rate (by 13 and 15 b·min-1), and physiological strain (by 1.3, 1.5) at the end of EHS compared with AL and FR, respectively. Cognitive performance (response time and accuracy) was not altered by fluid condition; however, mean response time improved (p < .05) for letter-digit recognition (by 56.7 ± 85.8 ms or 3.8%; p < .05) and pattern comparison (by 80.6 ± 57.4 ms or 7.1%; p < .001), but mean accuracy decreased in trail making (by 1.2 ± 1.4%; p = .01) after EHS (across all conditions). CONCLUSIONS: For recreational athletes, fluid intake effectively mitigated physiological strain induced by mild hypohydration; however, mild hypohydration resulting from EHS elicited no adverse changes in cognitive performance.

Effects of Acute Guarana (Paullinia cupana) Ingestion on Mental Performance and Vagal Modulation Compared to a Low Dose of Caffeine.

Guarana (GUA), a Brazilian seed extract, contains caffeine and other bioactive compounds that may have psychoactive effects. To assess the acute effects of GUA compared to a low dose of caffeine (CAF) on cognitive and mood parameters, twenty participants completed a double-blind, crossover experiment where they ingested capsules containing the following: (1) 100 mg CAF, (2) 500 mg GUA containing 130 mg caffeine, or (3) placebo (PLA). Cognitive tests (Simon and 2N-Back Task) were performed at the baseline (pre-ingestion) and 60 min after ingestion. The response time for the cognitive tests and heart rate variability were unaffected (p > 0.05) by treatment, although 2N-Back was overall faster (p = 0.001) across time. The accuracy in the 2N-Back Task showed a significant interaction effect (p = 0.029) due to higher post-ingestion versus pre-ingestion levels (p = 0.033), but only with the PLA. The supplements also had no effect on cognitive measures following physical fatigue (n = 11). There was an interaction effect on perceived mental energy, where the pre-ingestion of GUA had lower mental pep ratings compared to post-ingestion (p = 0.006) and post-exercise (p = 0.018) levels. Neither the acute ingestion of GUA nor low dose of CAF influenced cognitive performance or provided consistent benefit on mood or mental workload through vagal modulation. Additional investigations are beneficial to determining the lowest effective dose for CAF or GUA to influence mood and/or cognitive performance.

Effect of Guarana (Paullinia cupana) on Cognitive Performance: A Systematic Review and Meta-Analysis.

The plant extract guarana is known for its caffeine content and other bioactive ingredients, which purportedly may improve cognitive performance. Recent reviews have examined the effects of chronic supplementation of guarana in clinical populations; however, the acute effects of guarana on cognitive tasks, while of interest, have produced mixed results. Whether acute guarana ingestion improves human cognitive performance was assessed by performing a systematic review coupled with a meta-analysis. Eight placebo-controlled studies were identified and met the inclusion criteria providing data on 328 participants. The dose of guarana (37.5 to 500 mg) with reported caffeine content (4.3 to 100 mg) varied. Effect sizes (ESs) were calculated as the standardized mean difference and meta-analyses were completed using a random-effects model. The ESs for guarana averaged across a variety of cognitive measures and outcome variables were less than trivial (Hedge's g = 0.076, p = 0.14). Using a subgroup meta-analysis (Q = 12.9, p < 0.001), ESs indicating a faster response time for guarana vs. a placebo (g = 0.202, p = 0.005) differed from the accuracy measures (g = −0.077, p = 0.4) which were non-significant. For response time, guarana ingested in a capsule (g = 0.111) tended to differ (Q = 2.96, p = 0.085) compared to guarana when dissolved in liquid (g = 0.281). Meta-regression of the study ESs of overall cognitive task performance was not related to the guarana dose (R2 < 0.001) or to the time allowed prior to cognitive testing (R2 < 0.001). Acute guarana ingestion had a small effect on the response time (faster performance) during a variety of cognitive tasks without affecting the accuracy. Whether the changes were linked to the caffeine content or other bioavailable substances in guarana is unknown. Additional studies that directly compare matched doses of caffeine versus guarana are needed to understand its effects on cognitive performance.

Reply to Gurney, T.; Ronca, F. Comment on "Hack et al. Effect of Guarana (Paullinia cupana) on Cognitive Performance: A Systematic Review and Meta-Analysis. Nutrients 2023, 15, 434".

We thank Dr. Gurney for his interest and comment [...].

Early Prediction of Impending Exertional Heat Stroke With Wearable Multimodal Sensing and Anomaly Detection.

We employed wearable multimodal sensing (heart rate and triaxial accelerometry) with machine learning to enable early prediction of impending exertional heat stroke (EHS). US Army Rangers and Combat Engineers (N = 2,102) were instrumented while participating in rigorous 7-mile and 12-mile loaded rucksack timed marches. There were three EHS cases, and data from 478 Rangers were analyzed for model building and controls. The data-driven machine learning approach incorporated estimates of physiological strain (heart rate) and physical stress (estimated metabolic rate) trajectories, followed by reconstruction to obtain compressed representations which then fed into anomaly detection for EHS prediction. Impending EHS was predicted from 33 to 69 min before collapse. These findings demonstrate that low dimensional physiological stress to strain patterns with machine learning anomaly detection enables early prediction of impending EHS which will allow interventions that minimize or avoid pathophysiological sequelae. We describe how our approach can be expanded to other physical activities and enhanced with novel sensors.

Navigating a medical mystery in an elite athlete-severe dystonia induced by swimming.

Dystonia is a state of involuntary muscle contractions that cause repetitive or twisting movements. It may affect one or more parts of the body and sometimes the entire body. The condition can be mild or severe. In this unusual case, high-intensity swimming triggered the episodes of atypical functional movement disorder.

Low abundance of sweat duct Cl- channel CFTR in both healthy and cystic fibrosis athletes with exceptionally salty sweat during exercise.

To understand potential mechanisms explaining interindividual variability observed in human sweat sodium concentration ([Na(+)]), we investigated the relationship among [Na(+)] of thermoregulatory sweat, plasma membrane expression of Na(+) and Cl(-) transport proteins in biopsied human eccrine sweat ducts, and basal levels of vasopressin (AVP) and aldosterone. Lower ductal luminal membrane expression of the Cl(-) channel cystic fibrosis transmembrane conductance regulator (CFTR) was observed in immunofluorescent staining of sweat glands from healthy young adults identified as exceptionally "salty sweaters" (SS) (n = 6, P < 0.05) and from patients with cystic fibrosis (CF) (n = 6, P < 0.005) compared with ducts from healthy young adults with "typical" sweat [Na(+)] (control, n = 6). Genetic testing of healthy subjects did not reveal any heterozygotes ("carriers") for any of the 39 most common disease-causing CFTR mutations in the United States. SS had higher baseline plasma [AVP] compared with control (P = 0.029). Immunostaining to investigate a potential relationship between higher plasma [AVP] (and sweat [Na(+)]) and ductal membrane aquaporin-5 revealed for all groups a relatively sparse and location-dependent ductal expression of the water channel with localization primarily to the secretory coil. Availability of CFTR for NaCl transport across the ductal membrane appears related to the significant physiological variability observed in sweat salt concentration in apparently healthy humans. At present, a heritable link between healthy salty sweaters and the most prevalent disease-causing CFTR mutations cannot be established.

The Beverage Hydration Index: Influence of Electrolytes, Carbohydrate and Protein.

The beverage hydration index (BHI) facilitates a comparison of relative hydration properties of beverages using water as the standard. The additive effects of electrolytes, carbohydrate, and protein on rehydration were assessed using BHI. Nineteen healthy young adults completed four test sessions in randomized order: deionized water (W), electrolytes only (E), carbohydrate-electrolytes (C + E), and 2 g/L dipeptide (alanyl-glutamine)-electrolytes (AG + E). One liter of beverage was consumed, after which urine and body mass were obtained every 60 min through 240 min. Compared to W, BHI was higher (p = 0.007) for C + E (1.15 ± 0.17) after 120 min and for AG + E (p = 0.021) at 240 min (1.15 ± 0.20). BHI did not differ (p > 0.05) among E, C + E, or AG + E; however, E contributed the greatest absolute net effect (>12%) on BHI relative to W. Net fluid balance was lower for W (p = 0.048) compared to C + E and AG + E after 120 min. AG + E and E elicited higher (p < 0.001) overall urine osmolality vs. W. W also elicited greater reports of stomach bloating (p = 0.02) compared to AG + E and C + E. The addition of electrolytes alone (in the range of sports drinks) did not consistently improve BHI versus water; however, the combination with carbohydrate or dipeptides increased fluid retention, although this occurred earlier for the sports drink than the dipeptide beverage. Electrolyte content appears to make the largest contribution in hydration properties of beverages for young adults when consumed at rest.

Nature Versus Nurture: Have Performance Gaps Between Men and Women Reached an Asymptote?

Men outperform women in sports requiring muscular strength and/or endurance, but the relative influence of "nurture" versus "nature" remains difficult to quantify. Performance gaps between elite men and women are well documented using world records in second, centimeter, or kilogram sports. However, this approach is biased by global disparity in reward structures and opportunities for women. Despite policies enhancing female participation (Title IX legislation), US women only closed performance gaps by 2% and 5% in Olympic Trial swimming and running, respectively, from 1972 to 1980 (with no change thereafter through 2016). Performance gaps of 13% in elite middistance running and 8% in swimming (∼4-min duration) remain, the 5% differential between sports indicative of load carriage disadvantages of higher female body fatness in running. Conversely, sprint swimming exhibits a greater sex difference than sprint running, suggesting anthropometric/power advantages unique to swim-block starts. The ∼40-y plateau in the performance gap suggests a persistent dominance of biological influences (eg, longer limb levers, greater muscle mass, greater aerobic capacity, and lower fat mass) on performance. Current evidence suggests that women will not swim or run as fast as men in Olympic events, which speaks against eliminating sex segregation in these individual sports. Whether hormone reassignment sufficiently levels the playing field in Olympic sports for transgender females (born and socialized male) remains an issue to be tackled by sport-governing bodies.

Acoustical Emission Analysis by Unsupervised Graph Mining: A Novel Biomarker of Knee Health Status.

OBJECTIVE: To study knee acoustical emission patterns in subjects with acute knee injury immediately following injury and several months after surgery and rehabilitation. METHODS: We employed an unsupervised graph mining algorithm to visualize heterogeneity of the high-dimensional acoustical emission data, and then to derive a quantitative metric capturing this heterogeneity-the graph community factor (GCF). A total of 42 subjects participated in the studies. Measurements were taken once each from 33 healthy subjects with no known previous knee injury, and twice each from 9 subjects with unilateral knee injury: first, within seven days of the injury, and second, 4-6 months after surgery when the subjects were determined to start functional activities. Acoustical signals were processed to extract time and frequency domain features from multiple time windows of the recordings from both knees, and k-nearest neighbor graphs were then constructed based on these features. RESULTS: The GCF calculated from these graphs was found to be 18.5 ± 3.5 for healthy subjects, 24.8 ± 4.4 (p = 0.01) for recently injured, and 16.5 ± 4.7 (p = 0.01) at 4-6 months recovery from surgery. CONCLUSION: The objective GCF scores changes were consistent with a medical professional's subjective evaluations and subjective functional scores of knee recovery. SIGNIFICANCE: Unsupervised graph mining to extract GCF from knee acoustical emissions provides a novel, objective, and quantitative biomarker of knee injury and recovery that can be incorporated with a wearable joint health system for use outside of clinical settings, and austere/under resourced conditions, to aid treatment/therapy.

Wearable knee health system employing novel physiological biomarkers.

Knee injuries and chronic disorders, such as arthritis, affect millions of Americans, leading to missed workdays and reduced quality of life. Currently, after an initial diagnosis, there are few quantitative technologies available to provide sensitive subclinical feedback to patients regarding improvements or setbacks to their knee health status; instead, most assessments are qualitative, relying on patient-reported symptoms, performance during functional tests, and physical examinations. Recent advances have been made with wearable technologies for assessing the health status of the knee (and potentially other joints) with the goal of facilitating personalized rehabilitation of injuries and care for chronic conditions. This review describes our progress in developing wearable sensing technologies that enable quantitative physiological measurements and interpretation of knee health status. Our sensing system enables longitudinal quantitative measurements of knee sounds, swelling, and activity context during clinical and field situations. Importantly, we leverage machine-learning algorithms to fuse the low-level signal and feature data of the measured time series waveforms into higher level metrics of joint health. This paper summarizes the engineering validation, baseline physiological experiments, and human subject studies-both cross-sectional and longitudinal-that demonstrate the efficacy of using such systems for robust knee joint health assessment. We envision our sensor system complementing and advancing present-day practices to reduce joint reinjury risk, to optimize rehabilitation recovery time for a quicker return to activity, and to reduce health care costs.

American College of Sports Medicine position stand. Exertional heat illness during training and competition.

Exertional heat illness can affect athletes during high-intensity or long-duration exercise and result in withdrawal from activity or collapse during or soon after activity. These maladies include exercise associated muscle cramping, heat exhaustion, or exertional heatstroke. While certain individuals are more prone to collapse from exhaustion in the heat (i.e., not acclimatized, using certain medications, dehydrated, or recently ill), exertional heatstroke (EHS) can affect seemingly healthy athletes even when the environment is relatively cool. EHS is defined as a rectal temperature greater than 40 degrees C accompanied by symptoms or signs of organ system failure, most frequently central nervous system dysfunction. Early recognition and rapid cooling can reduce both the morbidity and mortality associated with EHS. The clinical changes associated with EHS can be subtle and easy to miss if coaches, medical personnel, and athletes do not maintain a high level of awareness and monitor at-risk athletes closely. Fatigue and exhaustion during exercise occur more rapidly as heat stress increases and are the most common causes of withdrawal from activity in hot conditions. When athletes collapse from exhaustion in hot conditions, the term heat exhaustion is often applied. In some cases, rectal temperature is the only discernable difference between severe heat exhaustion and EHS in on-site evaluations. Heat exhaustion will generally resolve with symptomatic care and oral fluid support. Exercise associated muscle cramping can occur with exhaustive work in any temperature range, but appears to be more prevalent in hot and humid conditions. Muscle cramping usually responds to rest and replacement of fluid and salt (sodium). Prevention strategies are essential to reducing the incidence of EHS, heat exhaustion, and exercise associated muscle cramping.

Limitations of body mass index for counseling individuals with unilateral lower extremity amputation.

BACKGROUND: Body composition is important for health screening, but appropriate methods for unilateral lower extremity amputees have not been validated. OBJECTIVES: To compare body mass index adjusted using Amputee Coalition equations (body mass index-Amputee Coalition) to dual-energy X-ray absorptiometry in unilateral lower limb amputees. STUDY DESIGN: Cross-sectional, experimental. METHODS: Thirty-eight men and women with lower limb amputations (transfemoral, transtibial, hip disarticulation, Symes) participated. Body mass index (mass/height2) was compared to body mass index corrected for limb loss (body mass index-Amputee Coalition). Accuracy of classification and extrapolation of percent body fat with body mass index was compared to dual-energy X-ray absorptiometry. RESULTS: Body mass index-Amputee Coalition increased body mass index (by ~ 1.1 kg/m2) but underestimated and mis-classified 60% of obese and overestimated 100% of lean individuals according to dual-energy X-ray absorptiometry. Estimated mean percent body fat (95% confidence interval) from body mass index-Amputee Coalition (28.3% (24.9%, 31.7%)) was similar to dual-energy X-ray absorptiometry percent body fat (29.5% (25.2%, 33.7%)) but both were significantly higher ( p < 0.05) than percent body fat estimated from uncorrected body mass index (23.6% (20.4%, 26.8%)). However, total errors for body mass index and body mass index-Amputee Coalition converted to percent body fat were unacceptably large (standard error of the estimate = 6.8%, 6.2% body fat) and the discrepancy between both methods and dual-energy X-ray absorptiometry was inversely related ( r = -0.59 and r = -0.66, p < 0.05) to the individual's level of body fatness. CONCLUSIONS: Body mass index (despite correction) underestimates health risk for obese patients and overestimates lean, muscular individuals with lower limb amputation. Clinical relevance Clinical recommendations for an ideal body mass based on body mass index-Amputee Coalition should not be relied upon in lower extremity amputees. This is of particular concern for obese lower extremity amputees whose health risk might be significantly underestimated based on body mass index despite a "correction" formula for limb loss.

Wearable Vector Electrical Bioimpedance System to Assess Knee Joint Health.

OBJECTIVE: We designed and validated a portable electrical bioimpedance (EBI) system to quantify knee joint health. METHODS: Five separate experiments were performed to demonstrate the: 1) ability of the EBI system to assess knee injury and recovery; 2) interday variability of knee EBI measurements; 3) sensitivity of the system to small changes in interstitial fluid volume; 4) reducing the error of EBI measurements using acceleration signals; and 5) use of the system with dry electrodes integrated to a wearable knee wrap. RESULTS: 1) The absolute difference in resistance ( R) and reactance (X) from the left to the right knee was able to distinguish injured and healthy knees (p < 0.05); the absolute difference in R decreased significantly (p < 0.05) in injured subjects following rehabilitation. 2) The average interday variability (standard deviation) of the absolute difference in knee R was 2.5 Ω and for X was 1.2 Ω. 3) Local heating/cooling resulted in a significant decrease/increase in knee R (p < 0.01). 4) The proposed subject position detection algorithm achieved 97.4% leave-one subject out cross-validated accuracy and 98.2% precision in detecting when the subject is in the correct position to take measurements. 5) Linear regression between the knee R and X measured using the wet electrodes and the designed wearable knee wrap were highly correlated ( R2 = 0.8 and 0.9, respectively). CONCLUSION: This study demonstrates the use of wearable EBI measurements in monitoring knee joint health. SIGNIFICANCE: The proposed wearable system has the potential for assessing knee joint health outside the clinic/lab and help guide rehabilitation.

Novel Methods for Sensing Acoustical Emissions From the Knee for Wearable Joint Health Assessment.

OBJECTIVE: We present the framework for wearable joint rehabilitation assessment following musculoskeletal injury. We propose a multimodal sensing (i.e., contact based and airborne measurement of joint acoustic emission) system for at-home monitoring. METHODS: We used three types of microphones-electret, MEMS, and piezoelectric film microphones-to obtain joint sounds in healthy collegiate athletes during unloaded flexion/extension, and we evaluated the robustness of each microphone's measurements via: 1) signal quality and 2) within-day consistency. RESULTS: First, air microphones acquired higher quality signals than contact microphones (signal-to-noise-and-interference ratio of 11.7 and 12.4 dB for electret and MEMS, respectively, versus 8.4 dB for piezoelectric). Furthermore, air microphones measured similar acoustic signatures on the skin and 5 cm off the skin (∼4.5× smaller amplitude). Second, the main acoustic event during repetitive motions occurred at consistent joint angles (intra-class correlation coefficient ICC(1, 1) = 0.94 and ICC(1, k) = 0.99). Additionally, we found that this angular location was similar between right and left legs, with asymmetry observed in only a few individuals. CONCLUSION: We recommend using air microphones for wearable joint sound sensing; for practical implementation of contact microphones in a wearable device, interface noise must be reduced. Importantly, we show that airborne signals can be measured consistently and that healthy left and right knees often produce a similar pattern in acoustic emissions. SIGNIFICANCE: These proposed methods have the potential for enabling knee joint acoustics measurement outside the clinic/lab and permitting long-term monitoring of knee health for patients rehabilitating an acute knee joint injury.

Conclusions of the II International and IV Spanish Hydration Congress. Toledo, Spain, 2nd-4th December, 2015.

Water is the major component of our organism representing about 60% of total body weight in adults and has to be obtained through the consumption of different foods and beverages as part of our diet. Water is an essential nutrient performing important functions, including transport of other nutrients, elimination of waste products, temperature regulation, lubrication and structural support. In this context, hydration through water has an essential role in health and wellness, which has been highly acknowledged in recent years among the health community experts such as nutritionists, dietitians, general practitioners, pharmacists, educators, as well as by physical activity and sport sciences experts and the general population.

Effect of race and musculoskeletal development on the accuracy of air plethysmography.

PURPOSE: The purpose of this study was to determine the effect of race and musculoskeletal development on the accuracy of estimates of body fatness (%fat) via air displacement plethysmography (AP). METHODS: Estimates of %fat were made via AP, hydrostatic weighing (HW), dual-energy x-ray absorptiometry (DXA), and the criterion, a four-component model (4C) in 64 black (B) and white (W) men, who were either resistance trained (RT) or served as controls (C). RESULTS: Based on a three-way ANOVA, there were no statistically significant three-way or race x musculoskeletal development interactions. There was no main effect of race on the validity of estimating %fat by AP; the mean bias between %FatAP and %Fat4C was similar for B (3.6% body fat) and W (3.7%). In addition, the density of the fat-free mass (Dffm) for B (1.098 +/- 0.002 g x mL) was not different than 1.10 g x mL. There was a significant effect of musculoskeletal development on the validity of the estimation of %fat from AP; the mean difference in %fat between %FatAP and %Fat4C was less in RT (1.5% body fat) than in C (5.3%), but a large SEE of 5.5% was observed for RT. A significant (P < 0.05) correlation was found between the mean bias between methods and body volume (-0.44) and mesomorphy (-0.55). CONCLUSIONS: Race does not affect the accuracy of estimating %fat by AP. Race-specific equations estimating %fat via densitometry (e.g., AP, HW) such as the Schutte are not justified, because Dffm is not greater than 1.10 g x mL. Estimation of %fat via AP is more accurate in larger individuals with high musculoskeletal development as a group, but individual results are highly variable.